- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.29 / $14.83 / $80.45
| Facility | | $14.29 | $14.83 | $80.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.29 / $14.83 / $18.09
| Professional | | $14.29 | $14.83 | $18.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.26 / $16.28 / $19.01
| Facility | | $11.26 | $16.28 | $19.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.79 / $2.11 / $2.11
| Professional | | $1.79 | $2.11 | $2.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.09 / $28.94 / $41,999.58
| Facility | | $18.09 | $28.94 | $41,999.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.89 / $25.33 / $336.07
| Professional | | $19.89 | $25.33 | $336.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.76 / $13.81 / $21.71
| Facility | | $11.76 | $13.81 | $21.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.35 / $25.81 / $87.19
| Professional | | $20.35 | $25.81 | $87.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Professional | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.60 / $10.85 / $19.89
| Professional | | $7.60 | $10.85 | $19.89 |