- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.68 / $11.84 / $12.79
| Facility | | $11.68 | $11.84 | $12.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.20 / $12.00 / $16.11
| Professional | | $7.20 | $12.00 | $16.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.86 / $14.86 / $14.86
| Professional | | $14.86 | $14.86 | $14.86 |
- 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
- $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
- $36.60 / $90.00 / $90.00
| Facility | | $36.60 | $90.00 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.22 / $151.96 / $158.04
| Professional | | $135.22 | $151.96 | $158.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.00 / $18.03 / $33.61
| Facility | | $12.00 | $18.03 | $33.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.33 / $17.13 / $18.03
| Professional | | $15.33 | $17.13 | $18.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.67 / $20.23 / $31.55
| Professional | | $17.67 | $20.23 | $31.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.00 / $18.03 / $33.61
| Facility | | $12.00 | $18.03 | $33.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.36 / $7.36 / $14.99
| Professional | | $7.36 | $7.36 | $14.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.37 / $8.18 / $12.41
| Professional | | $6.37 | $8.18 | $12.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.03 / $18.03 / $24.34
| Professional | | $18.03 | $18.03 | $24.34 |