- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.45 / $5.53 / $5.97
| Facility | | $5.45 | $5.53 | $5.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.09 / $5.97 / $8.22
| Professional | | $5.09 | $5.97 | $8.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.42 / $6.00 / $12.71
| Professional | | $4.42 | $6.00 | $12.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.51 / $10.71 / $23.10
| Facility | | $6.51 | $10.71 | $23.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.94 / $6.94 / $6.94
| Professional | | $6.94 | $6.94 | $6.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.17 / $7.06 / $10.59
| Professional | | $6.17 | $7.06 | $10.59 |
- 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
- $9.86 / $9.86 / $9.86
| Facility | | $9.86 | $9.86 | $9.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.44 / $3.44 / $3.44
| Professional | | $3.44 | $3.44 | $3.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.09 / $90.00 / $90.00
| Facility | | $17.09 | $90.00 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.00 / $137.82 / $143.33
| Professional | | $74.00 | $137.82 | $143.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.60 / $9.86 / $29.08
| Facility | | $5.60 | $9.86 | $29.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.16 / $8.00 / $8.42
| Professional | | $7.16 | $8.00 | $8.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.25 / $9.44 / $14.73
| Professional | | $8.25 | $9.44 | $14.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.69 / $10.17 / $29.08
| Facility | | $5.69 | $10.17 | $29.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.44 / $3.44 / $7.00
| Professional | | $3.44 | $3.44 | $7.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.98 / $3.95 / $5.78
| Professional | | $2.98 | $3.95 | $5.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.42 / $8.42 / $11.37
| Professional | | $8.42 | $8.42 | $11.37 |