- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.74 / $10.89 / $11.76
| Facility | | $10.74 | $10.89 | $11.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.97 / $10.89 / $14.81
| Professional | | $7.97 | $10.89 | $14.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.82 / $21.51 / $45.51
| Facility | | $12.82 | $21.51 | $45.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.67 / $13.67 / $13.67
| Professional | | $13.67 | $13.67 | $13.67 |
- 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
- $19.43 / $19.43 / $19.43
| Facility | | $19.43 | $19.43 | $19.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $6.76 / $6.76
| Professional | | $6.76 | $6.76 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.65 / $90.00 / $90.00
| Facility | | $33.65 | $90.00 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.35 / $167.85 / $174.56
| Professional | | $124.35 | $167.85 | $174.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.04 / $16.57 / $35.40
| Facility | | $11.04 | $16.57 | $35.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.09 / $15.75 / $19.07
| Professional | | $14.09 | $15.75 | $19.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.25 / $18.60 / $29.02
| Professional | | $16.25 | $18.60 | $29.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.04 / $16.57 / $35.40
| Facility | | $11.04 | $16.57 | $35.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $6.76 / $13.79
| Professional | | $6.76 | $6.76 | $13.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.86 / $7.52 / $11.40
| Professional | | $5.86 | $7.52 | $11.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.57 / $16.57 / $22.38
| Professional | | $16.57 | $16.57 | $22.38 |