- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.31 / $12.23 / $37.04
| Facility | | $9.31 | $12.23 | $37.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.38 / $14.35 / $37.04
| Professional | | $9.38 | $14.35 | $37.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.68 / $13.68 / $13.68
| Professional | | $13.68 | $13.68 | $13.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.95 / $6.29 / $25.35
| Professional | | $4.95 | $6.29 | $25.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.84 / $12.73 / $12.73
| Facility | | $11.84 | $12.73 | $12.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.73 / $12.73 / $12.73
| Professional | | $12.73 | $12.73 | $12.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.80 / $17.80 / $17.80
| Facility | | $17.80 | $17.80 | $17.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.20 / $6.20 / $6.20
| Professional | | $6.20 | $6.20 | $6.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.20 / $27.82 / $332.00
| Facility | | $15.20 | $27.82 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.96 / $20.58 / $32.97
| Professional | | $15.96 | $20.58 | $32.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.28 / $28.28 / $28.28
| Facility | | $28.28 | $28.28 | $28.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.73 / $30.05 / $30.05
| Professional | | $12.73 | $30.05 | $30.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.70 / $12.70 / $12.70
| Professional | | $12.70 | $12.70 | $12.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.80 / $17.80 / $597.00
| Facility | | $17.80 | $17.80 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.20 / $6.20 / $26.00
| Professional | | $6.20 | $6.20 | $26.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $8.35 / $16.76
| Professional | | $5.05 | $8.35 | $16.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.28 / $28.28 / $30.30
| Facility | | $28.28 | $28.28 | $30.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.28 / $28.28 / $30.05
| Professional | | $28.28 | $28.28 | $30.05 |