- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.39 / $18.05 / $23.84
| Facility | | $10.39 | $18.05 | $23.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.39 / $10.49 / $12.57
| Professional | | $10.39 | $10.49 | $12.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.33 / $26.15 / $50.10
| Facility | | $10.33 | $26.15 | $50.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.59 / $10.59 / $10.59
| Professional | | $10.59 | $10.59 | $10.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.40 / $10.40 / $80.00
| Facility | | $10.40 | $10.40 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.80 / $10.39 / $11.26
| Facility | | $9.80 | $10.39 | $11.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.39 / $10.39 / $10.39
| Professional | | $10.39 | $10.39 | $10.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $100.00 / $100.00
| Facility | | $75.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $796.88 / $796.88 / $796.88
| Professional | | $796.88 | $796.88 | $796.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.05 / $10.39 / $18.18
| Facility | | $10.05 | $10.39 | $18.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.39 / $10.60 / $17.14
| Professional | | $10.39 | $10.60 | $17.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.40 / $11.44 / $23.40
| Professional | | $9.40 | $11.44 | $23.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.80 / $10.39 / $18.69
| Facility | | $9.80 | $10.39 | $18.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.39 / $10.39 / $13.00
| Professional | | $10.39 | $10.39 | $13.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.70 / $17.18 / $17.18
| Facility | | $12.70 | $17.18 | $17.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.39 / $11.01 / $11.64
| Professional | | $10.39 | $11.01 | $11.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.39 / $10.41 / $14.55
| Professional | | $10.39 | $10.41 | $14.55 |