- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.92 / $36.33 / $119.46
| Facility | | $11.92 | $36.33 | $119.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.64 / $11.36 / $13.59
| Professional | | $10.64 | $11.36 | $13.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.88 / $26.11 / $86.00
| Facility | | $10.88 | $26.11 | $86.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $11.92 / $29.03
| Professional | | $7.15 | $11.92 | $29.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.09 / $33.59 / $59.76
| Facility | | $21.09 | $33.59 | $59.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.20 / $11.20 / $15.26
| Professional | | $11.20 | $11.20 | $15.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.33 / $17.73 / $40.72
| Facility | | $8.33 | $17.73 | $40.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $13.18 / $20.34
| Professional | | $7.08 | $13.18 | $20.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.27 / $17.27 / $20.32
| Professional | | $17.27 | $17.27 | $20.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.92 / $16.52 / $44.35
| Professional | | $11.92 | $16.52 | $44.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.27 / $14.03 / $146.51
| Facility | | $11.27 | $14.03 | $146.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.11 / $86.00 / $86.00
| Facility | | $26.11 | $86.00 | $86.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.72 / $8.00 / $25.17
| Professional | | $5.72 | $8.00 | $25.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.91 / $10.00 / $21.34
| Professional | | $5.91 | $10.00 | $21.34 |