- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $8.28 / $21.65
| Facility | | $6.31 | $8.28 | $21.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.49 / $8.13 / $21.65
| Professional | | $5.49 | $8.13 | $21.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.35 / $4.26 / $15.98
| Professional | | $3.35 | $4.26 | $15.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.03 / $8.64 / $8.64
| Facility | | $8.03 | $8.64 | $8.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.64 / $8.64 / $8.64
| Professional | | $8.64 | $8.64 | $8.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.06 / $12.06 / $12.06
| Facility | | $12.06 | $12.06 | $12.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.20 / $4.20 / $4.20
| Professional | | $4.20 | $4.20 | $4.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.29 / $18.82 / $332.00
| Facility | | $10.29 | $18.82 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.80 / $13.93 / $22.33
| Professional | | $10.80 | $13.93 | $22.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.69 / $16.69 / $16.69
| Facility | | $16.69 | $16.69 | $16.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.64 / $17.73 / $17.73
| Professional | | $8.64 | $17.73 | $17.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.06 / $12.06 / $597.00
| Facility | | $12.06 | $12.06 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.20 / $4.20 / $17.63
| Professional | | $4.20 | $4.20 | $17.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.42 / $5.78 / $11.56
| Professional | | $3.42 | $5.78 | $11.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.69 / $16.69 / $16.69
| Facility | | $16.69 | $16.69 | $16.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.69 / $16.69 / $17.73
| Professional | | $16.69 | $16.69 | $17.73 |