- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.15 / $9.39 / $17.07
| Facility | | $7.15 | $9.39 | $17.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.22 / $8.11 / $17.07
| Professional | | $6.22 | $8.11 | $17.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $4.83 / $18.11
| Professional | | $3.80 | $4.83 | $18.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.10 / $9.78 / $9.78
| Facility | | $9.10 | $9.78 | $9.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.78 / $9.78 / $9.78
| Professional | | $9.78 | $9.78 | $9.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.68 / $13.68 / $13.68
| Facility | | $13.68 | $13.68 | $13.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.76 / $4.76 / $4.76
| Professional | | $4.76 | $4.76 | $4.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.67 / $21.36 / $332.00
| Facility | | $11.67 | $21.36 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.25 / $15.80 / $25.32
| Professional | | $12.25 | $15.80 | $25.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.01 / $13.01 / $13.01
| Facility | | $13.01 | $13.01 | $13.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.78 / $13.83 / $13.83
| Professional | | $9.78 | $13.83 | $13.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.68 / $13.68 / $597.00
| Facility | | $13.68 | $13.68 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.76 / $4.76 / $19.98
| Professional | | $4.76 | $4.76 | $19.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.88 / $6.67 / $12.88
| Professional | | $3.88 | $6.67 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.01 / $13.01 / $13.93
| Facility | | $13.01 | $13.01 | $13.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.01 / $13.01 / $13.83
| Professional | | $13.01 | $13.01 | $13.83 |