- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.78 / $8.97 / $13.63
| Facility | | $8.78 | $8.97 | $13.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.58 / $9.11 / $9.34
| Professional | | $7.58 | $9.11 | $9.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.16 / $9.16 / $12.26
| Professional | | $9.16 | $9.16 | $12.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.16 / $9.16 / $10.08
| Facility | | $9.16 | $9.16 | $10.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.16 / $9.16 / $9.16
| Professional | | $9.16 | $9.16 | $9.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.34 / $12.73 / $85.00
| Facility | | $9.34 | $12.73 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.34 / $9.34 / $12.45
| Professional | | $9.34 | $9.34 | $12.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.38 / $16.61 / $332.00
| Facility | | $10.38 | $16.61 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.38 / $10.38 / $14.64
| Professional | | $10.38 | $10.38 | $14.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.16 / $9.16 / $10.38
| Facility | | $9.16 | $9.16 | $10.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.16 / $10.38 / $10.38
| Professional | | $9.16 | $10.38 | $10.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.36 / $85.00 / $555.00
| Facility | | $12.36 | $85.00 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.34 / $9.34 / $13.12
| Professional | | $9.34 | $9.34 | $13.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.16 / $9.16 / $12.36
| Professional | | $9.16 | $9.16 | $12.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.38 / $10.38 / $10.38
| Facility | | $10.38 | $10.38 | $10.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.16 / $10.38 / $10.38
| Professional | | $9.16 | $10.38 | $10.38 |