- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.08 / $17.18 / $26.64
| Facility | | $13.08 | $17.18 | $26.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.96 / $14.85 / $26.64
| Professional | | $9.96 | $14.85 | $26.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.96 / $8.84 / $33.11
| Professional | | $6.96 | $8.84 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.64 / $17.89 / $17.89
| Facility | | $16.64 | $17.89 | $17.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.89 / $17.89 / $17.89
| Professional | | $17.89 | $17.89 | $17.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.02 / $25.02 / $25.02
| Facility | | $25.02 | $25.02 | $25.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $8.71 / $8.71
| Professional | | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.35 / $39.07 / $332.00
| Facility | | $21.35 | $39.07 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.42 / $28.91 / $46.33
| Professional | | $22.42 | $28.91 | $46.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.36 / $20.36 / $20.36
| Facility | | $20.36 | $20.36 | $20.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.89 / $21.63 / $21.63
| Professional | | $17.89 | $21.63 | $21.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.02 / $25.02 / $597.00
| Facility | | $25.02 | $25.02 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $8.71 / $36.54
| Professional | | $8.71 | $8.71 | $36.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.10 / $12.81 / $23.49
| Professional | | $7.10 | $12.81 | $23.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.36 / $20.36 / $20.36
| Facility | | $20.36 | $20.36 | $20.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.36 / $20.36 / $21.63
| Professional | | $20.36 | $20.36 | $21.63 |