- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.05 / $13.63 / $22.13
| Facility | | $9.05 | $13.63 | $22.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.05 / $15.95 / $22.55
| Professional | | $9.05 | $15.95 | $22.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,845.00 / $5,646.00 / $8,585.00
| Facility | | $1,845.00 | $5,646.00 | $8,585.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $13.92 / $27.61
| Professional | | $7.08 | $13.92 | $27.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.62 / $7.62 / $7.62
| Facility | | $7.62 | $7.62 | $7.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.18 / $18.87 / $32.06
| Professional | | $10.18 | $18.87 | $32.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.20 / $50.20 / $1,300.00
| Facility | | $50.20 | $50.20 | $1,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $211.00 / $244.22 / $252.28
| Professional | | $211.00 | $244.22 | $252.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.53 / $19.13 / $36.01
| Facility | | $9.53 | $19.13 | $36.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.93 / $14.72 / $30.00
| Professional | | $10.93 | $14.72 | $30.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.16 / $17.62 / $35.24
| Professional | | $8.16 | $17.62 | $35.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.53 / $19.39 / $40.50
| Facility | | $9.53 | $19.39 | $40.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.38 / $20.01 / $32.11
| Professional | | $10.38 | $20.01 | $32.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.46 / $17.80 / $28.49
| Professional | | $13.46 | $17.80 | $28.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.63 / $16.52 / $23.27
| Professional | | $14.63 | $16.52 | $23.27 |