- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.34 / $18.62 / $33.86
| Facility | | $13.34 | $18.62 | $33.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $15.30 / $20.52
| Professional | | $2.15 | $15.30 | $20.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.65 / $15.30 / $15.30
| Professional | | $2.65 | $15.30 | $15.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.43 / $8.43 / $8.85
| Facility | | $8.43 | $8.43 | $8.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.43 / $8.43 / $8.43
| Professional | | $8.43 | $8.43 | $8.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.86 / $14.43 / $15.30
| Facility | | $8.86 | $14.43 | $15.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.30 / $15.30 / $15.30
| Professional | | $15.30 | $15.30 | $15.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.43 / $21.65 / $332.00
| Facility | | $14.43 | $21.65 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $16.60 / $38.51
| Professional | | $16.60 | $16.60 | $38.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.30 / $15.30 / $15.87
| Facility | | $15.30 | $15.30 | $15.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.30 / $15.30 / $15.87
| Professional | | $15.30 | $15.30 | $15.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.05 / $13.05 / $31.60
| Facility | | $13.05 | $13.05 | $31.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.86 / $14.43 / $555.00
| Facility | | $8.86 | $14.43 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $15.30 / $15.76
| Professional | | $1.00 | $15.30 | $15.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.30 / $15.30 / $27.58
| Professional | | $15.30 | $15.30 | $27.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.87 / $15.87 / $15.87
| Facility | | $15.87 | $15.87 | $15.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.12 / $15.30 / $15.87
| Professional | | $1.12 | $15.30 | $15.87 |