- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $75.86 / $389.05
| Facility | | $19.05 | $75.86 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $8.71 / $41.69
| Professional | | $7.76 | $8.71 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $14.79 / $100.00
| Facility | | $9.55 | $14.79 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.47 / $10.47 / $22.39
| Professional | | $4.47 | $10.47 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $25.70 / $40.74
| Facility | | $20.42 | $25.70 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $13.18 / $13.18
| Professional | | $10.23 | $13.18 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $16.98 / $40.74
| Facility | | $8.32 | $16.98 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $12.88 / $18.20
| Professional | | $7.76 | $12.88 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $61.66 / $7,079.46
| Facility | | $12.59 | $61.66 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $14.13 / $19.05
| Professional | | $10.96 | $14.13 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $32.36
| Professional | | $10.47 | $10.47 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $19.95 / $120.23
| Facility | | $12.88 | $19.95 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $14.79 / $100.00
| Facility | | $9.55 | $14.79 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.13 / $10.47 / $22.39
| Professional | | $5.13 | $10.47 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $12.30 / $24.55
| Facility | | $9.33 | $12.30 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $10.96 / $15.85
| Professional | | $9.33 | $10.96 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $10.47 / $17.38
| Facility | | $5.25 | $10.47 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $8.91 / $25.12
| Professional | | $3.16 | $8.91 | $25.12 |