- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.66 / $20.36 / $200.00
| Facility | | $14.66 | $20.36 | $200.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.74 / $9.94 / $16.32
| Professional | | $8.74 | $9.94 | $16.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.46 / $22.59 / $62.93
| Professional | | $9.46 | $22.59 | $62.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.23 / $29.48 / $39.19
| Facility | | $25.23 | $29.48 | $39.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.84 / $34.29 / $38.97
| Professional | | $11.84 | $34.29 | $38.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.74 / $10.99 / $19.05
| Facility | | $8.74 | $10.99 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.72 / $11.57 / $20.76
| Facility | | $8.72 | $11.57 | $20.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.10 / $27.11 / $63.94
| Professional | | $11.10 | $27.11 | $63.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.34 / $65.00 / $85.00
| Professional | | $34.34 | $65.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.74 / $11.90 / $19.61
| Facility | | $8.74 | $11.90 | $19.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.10 / $22.88 / $32.93
| Professional | | $18.10 | $22.88 | $32.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.30 / $70.00 / $70.00
| Facility | | $23.30 | $70.00 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.44 / $41.94 / $63.94
| Professional | | $14.44 | $41.94 | $63.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.85 / $67.22 / $76.75
| Facility | | $55.85 | $67.22 | $76.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.06 / $61.06 / $80.51
| Professional | | $61.06 | $61.06 | $80.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.94 / $25.70 / $45.67
| Professional | | $10.94 | $25.70 | $45.67 |