- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.84 / $69.18 / $144.52
| Facility | | $12.84 | $69.18 | $144.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.02 / $9.93 / $26.78
| Professional | | $8.02 | $9.93 | $26.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.02 / $9.30 / $24.77
| Professional | | $8.02 | $9.30 | $24.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.06 / $36.82 / $100.00
| Facility | | $14.06 | $36.82 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.18 / $12.73 / $23.10
| Professional | | $8.18 | $12.73 | $23.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.01 / $27.41 / $44.73
| Facility | | $9.01 | $27.41 | $44.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $19.10 / $36.72
| Professional | | $12.05 | $19.10 | $36.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.53 / $12.92 / $14.21
| Professional | | $9.53 | $12.92 | $14.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.39 / $18.75 / $88.04
| Facility | | $13.39 | $18.75 | $88.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.05 / $13.39 / $13.39
| Facility | | $12.05 | $13.39 | $13.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $12.05 / $12.05
| Professional | | $12.05 | $12.05 | $12.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.40 / $22.09 / $36.82
| Facility | | $15.40 | $22.09 | $36.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.03 / $13.39 / $35.93
| Professional | | $10.03 | $13.39 | $35.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $6.03 / $13.39
| Professional | | $5.62 | $6.03 | $13.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.94 / $6.94 / $6.94
| Professional | | $6.94 | $6.94 | $6.94 |