- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.32 / $13.56 / $17.62
| Facility | | $10.32 | $13.56 | $17.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.25 / $11.72 / $16.23
| Professional | | $8.25 | $11.72 | $16.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $6.97 / $26.12
| Professional | | $5.50 | $6.97 | $26.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.13 / $14.12 / $14.12
| Facility | | $13.13 | $14.12 | $14.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.12 / $14.12 / $14.12
| Professional | | $14.12 | $14.12 | $14.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.73 / $19.73 / $19.73
| Facility | | $19.73 | $19.73 | $19.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.87 / $6.87 / $6.87
| Professional | | $6.87 | $6.87 | $6.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.82 / $30.80 / $332.00
| Facility | | $16.82 | $30.80 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.67 / $22.79 / $36.52
| Professional | | $17.67 | $22.79 | $36.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.44 / $12.44 / $12.44
| Facility | | $12.44 | $12.44 | $12.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.44 / $13.22 / $14.12
| Professional | | $12.44 | $13.22 | $14.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.73 / $19.73 / $597.00
| Facility | | $19.73 | $19.73 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.87 / $6.87 / $28.82
| Professional | | $6.87 | $6.87 | $28.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.60 / $9.61 / $18.89
| Professional | | $5.60 | $9.61 | $18.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.44 / $12.44 / $13.23
| Facility | | $12.44 | $12.44 | $13.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.44 / $12.44 / $13.22
| Professional | | $12.44 | $12.44 | $13.22 |