- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.21 / $8.53 / $15.80
| Facility | | $7.21 | $8.53 | $15.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.21 / $8.66 / $12.36
| Professional | | $7.21 | $8.66 | $12.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.61 / $20.00 / $39.22
| Facility | | $19.61 | $20.00 | $39.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.00 / $11.00 / $30.80
| Professional | | $11.00 | $11.00 | $30.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.20 / $16.34 / $16.34
| Facility | | $15.20 | $16.34 | $16.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.34 / $16.34 / $16.34
| Professional | | $16.34 | $16.34 | $16.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.23 / $11.23 / $11.23
| Facility | | $11.23 | $11.23 | $11.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $9.55 / $11.23
| Professional | | $9.55 | $9.55 | $11.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.61 / $44.12 / $332.00
| Facility | | $19.61 | $44.12 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.57 / $14.71 / $35.89
| Professional | | $11.57 | $14.71 | $35.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.45 / $12.17 / $16.34
| Professional | | $11.45 | $12.17 | $16.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.23 / $11.23 / $555.00
| Facility | | $11.23 | $11.23 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $11.23 / $29.06
| Professional | | $9.55 | $11.23 | $29.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.52 / $11.77 / $17.97
| Professional | | $6.52 | $11.77 | $17.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.45 / $11.45 / $11.45
| Facility | | $11.45 | $11.45 | $11.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.45 / $11.45 / $12.17
| Professional | | $11.45 | $11.45 | $12.17 |