- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $44.67 / $100.00
| Facility | | $18.20 | $44.67 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $15.85 / $41.69
| Professional | | $12.88 | $15.85 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $10.72 / $12.59
| Professional | | $10.72 | $10.72 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $19.05 / $33.11
| Facility | | $16.60 | $19.05 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $10.96 / $23.44
| Professional | | $8.91 | $10.96 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $14.45
| Professional | | $14.45 | $14.45 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $20.89
| Facility | | $10.00 | $10.00 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $18.20 / $24.55
| Professional | | $11.75 | $18.20 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $11.75 / $60.26
| Facility | | $11.75 | $11.75 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $11.75 / $25.70
| Professional | | $9.33 | $11.75 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $30.20 / $134.90
| Facility | | $12.02 | $30.20 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $13.49 / $25.12
| Professional | | $9.33 | $13.49 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $14.79 / $22.39
| Professional | | $12.30 | $14.79 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $21.88 / $21.88
| Facility | | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $19.05 / $36.31
| Professional | | $11.75 | $19.05 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.46 / $12.30 / $18.20
| Facility | | $6.46 | $12.30 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $10.72 / $21.88
| Professional | | $7.59 | $10.72 | $21.88 |