- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.13 / $9.18 / $56.87
| Professional | | $6.13 | $9.18 | $56.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.15 / $1.28 / $33.63
| Facility | | $1.15 | $1.28 | $33.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.78 / $14.74 / $26.04
| Professional | | $12.78 | $14.74 | $26.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.35 / $23.35 / $23.35
| Facility | | $23.35 | $23.35 | $23.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.65 / $12.14 / $20.18
| Professional | | $10.65 | $12.14 | $20.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.46 / $13.24 / $15.66
| Facility | | $11.46 | $13.24 | $15.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.25 / $13.24 / $23.25
| Professional | | $11.25 | $13.24 | $23.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.59 / $15.59 / $18.71
| Professional | | $15.59 | $15.59 | $18.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.83 / $13.80 / $26.61
| Professional | | $11.83 | $13.80 | $26.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.00 / $93.55 / $93.62
| Facility | | $76.00 | $93.55 | $93.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.36 / $13.24 / $19.72
| Facility | | $6.36 | $13.24 | $19.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.25 / $13.24 / $13.64
| Professional | | $11.25 | $13.24 | $13.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.20 / $37.20 / $37.20
| Professional | | $37.20 | $37.20 | $37.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.59 / $15.59 / $15.77
| Professional | | $15.59 | $15.59 | $15.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.73 / $9.83 / $16.85
| Professional | | $7.73 | $9.83 | $16.85 |