- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.67 / $10.68 / $55.94
| Facility | | $8.67 | $10.68 | $55.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.67 / $10.68 / $10.68
| Professional | | $8.67 | $10.68 | $10.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.75 / $10.68 / $24.68
| Professional | | $8.75 | $10.68 | $24.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.83 / $12.83 / $12.83
| Facility | | $12.83 | $12.83 | $12.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.83 / $12.83 / $12.83
| Professional | | $12.83 | $12.83 | $12.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.37 / $85.00 / $85.00
| Facility | | $12.37 | $85.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.87 / $7.87 / $12.72
| Professional | | $7.87 | $7.87 | $12.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.92 / $10.92 / $22.39
| Facility | | $10.92 | $10.92 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.68 / $10.68 / $38,249.62
| Professional | | $10.68 | $10.68 | $38,249.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.32 / $10.48 / $11.11
| Professional | | $9.32 | $10.48 | $11.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.37 / $85.00 / $597.00
| Facility | | $12.37 | $85.00 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.87 / $8.97 / $12.57
| Professional | | $7.87 | $8.97 | $12.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.57 / $12.57 / $18.32
| Professional | | $12.57 | $12.57 | $18.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.16 / $10.16 / $11.03
| Facility | | $10.16 | $10.16 | $11.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.16 / $10.48 / $11.03
| Professional | | $10.16 | $10.48 | $11.03 |