- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.61 / $8.51 / $50.43
| Facility | | $6.61 | $8.51 | $50.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.19 / $8.80 / $31.20
| Professional | | $7.19 | $8.80 | $31.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $14.13 / $35.32
| Professional | | $14.13 | $14.13 | $35.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.00 / $14.00 / $22.50
| Facility | | $14.00 | $14.00 | $22.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.00 / $14.00 / $14.00
| Professional | | $14.00 | $14.00 | $14.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.12 / $21.12 / $21.41
| Facility | | $21.12 | $21.12 | $21.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.42 / $15.42 / $21.12
| Professional | | $15.42 | $15.42 | $21.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.18 / $22.73 / $22.73
| Professional | | $18.18 | $22.73 | $22.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.73 / $22.73 / $22.73
| Facility | | $22.73 | $22.73 | $22.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $11.72 / $22.73
| Professional | | $11.03 | $11.72 | $22.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.38 / $15.38 / $15.38
| Professional | | $15.38 | $15.38 | $15.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.12 / $21.12 / $555.00
| Facility | | $21.12 | $21.12 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.42 / $21.12 / $62.19
| Professional | | $15.42 | $21.12 | $62.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.46 / $8.00 / $9.67
| Facility | | $6.46 | $8.00 | $9.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.37 / $9.55 / $15.94
| Professional | | $6.37 | $9.55 | $15.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.84 / $11.03 / $11.03
| Facility | | $10.84 | $11.03 | $11.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $11.03 / $22.73
| Professional | | $11.03 | $11.03 | $22.73 |