- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.87 / $7.26 / $7.53
| Facility | | $6.87 | $7.26 | $7.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.35 / $7.40 / $12.85
| Professional | | $6.35 | $7.40 | $12.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,456.92 / $5,821.21 / $8,577.84
| Facility | | $5,456.92 | $5,821.21 | $8,577.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.66 / $11.66 / $14.57
| Professional | | $11.66 | $11.66 | $14.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.65 / $28.65 / $28.65
| Facility | | $28.65 | $28.65 | $28.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.91 / $20.91 / $28.65
| Professional | | $20.91 | $20.91 | $28.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $90.00 / $90.00
| Facility | | $80.00 | $90.00 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.64 / $97.39 / $113.18
| Professional | | $93.64 | $97.39 | $113.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.58 / $12.23 / $22.11
| Facility | | $6.58 | $12.23 | $22.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.72 / $6.58 / $12.23
| Professional | | $5.72 | $6.58 | $12.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.15 / $23.23 / $25.96
| Professional | | $22.15 | $23.23 | $25.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.58 / $12.23 / $25.46
| Facility | | $6.58 | $12.23 | $25.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.91 / $20.91 / $28.65
| Professional | | $20.91 | $20.91 | $28.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.22 / $8.59 / $15.97
| Professional | | $7.22 | $8.59 | $15.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.62 / $26.62 / $26.62
| Professional | | $26.62 | $26.62 | $26.62 |