- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.05 / $14.53 / $19.14
| Facility | | $11.05 | $14.53 | $19.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.20 / $12.56 / $19.14
| Professional | | $7.20 | $12.56 | $19.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.39 / $20.39 / $20.39
| Professional | | $20.39 | $20.39 | $20.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.89 / $7.47 / $27.97
| Professional | | $5.89 | $7.47 | $27.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.06 / $15.12 / $15.12
| Facility | | $14.06 | $15.12 | $15.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.12 / $15.12 / $15.12
| Professional | | $15.12 | $15.12 | $15.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.13 / $21.13 / $21.13
| Facility | | $21.13 | $21.13 | $21.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.36 / $7.36 / $7.36
| Professional | | $7.36 | $7.36 | $7.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.03 / $32.99 / $332.00
| Facility | | $18.03 | $32.99 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.93 / $24.70 / $39.13
| Professional | | $18.93 | $24.70 | $39.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.42 / $14.42 / $14.42
| Facility | | $14.42 | $14.42 | $14.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.42 / $15.32 / $15.32
| Professional | | $14.42 | $15.32 | $15.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.13 / $21.13 / $597.00
| Facility | | $21.13 | $21.13 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.36 / $7.36 / $30.88
| Professional | | $7.36 | $7.36 | $30.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $10.82 / $22.72
| Professional | | $6.00 | $10.82 | $22.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.42 / $14.42 / $15.67
| Facility | | $14.42 | $14.42 | $15.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.42 / $14.42 / $15.32
| Professional | | $14.42 | $14.42 | $15.32 |