- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.54 / $23.08 / $8,684.34
| Facility | | $10.54 | $23.08 | $8,684.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.54 / $10.65 / $14.54
| Professional | | $10.54 | $10.65 | $14.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.12 / $12.12 / $13.06
| Professional | | $12.12 | $12.12 | $13.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.94 / $10.54 / $16.93
| Facility | | $9.94 | $10.54 | $16.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.54 / $10.54 / $10.54
| Professional | | $10.54 | $10.54 | $10.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.31 / $10.54 / $10.54
| Facility | | $9.31 | $10.54 | $10.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.27 / $10.54 / $10.54
| Professional | | $5.27 | $10.54 | $10.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.07 / $16.58 / $24.11
| Professional | | $15.07 | $16.58 | $24.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.54 / $11.17 / $11.73
| Professional | | $10.54 | $11.17 | $11.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.54 / $12.12 / $12.12
| Professional | | $10.54 | $12.12 | $12.12 |