- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.04 / $5.04 / $93.08
| Professional | | $5.04 | $5.04 | $93.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.06 / $55.99 / $58.19
| Facility | | $24.06 | $55.99 | $58.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $22.91
| Professional | | $22.91 | $22.91 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.04 / $42.12 / $64.62
| Facility | | $36.04 | $42.12 | $64.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.52 / $64.30 / $73.06
| Professional | | $16.52 | $64.30 | $73.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.07 / $16.07 / $29.32
| Facility | | $16.07 | $16.07 | $29.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.61 / $16.07 / $112.04
| Facility | | $7.61 | $16.07 | $112.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.81 / $19.34 / $43.93
| Professional | | $11.81 | $19.34 | $43.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.00 / $65.00 / $3,000.00
| Professional | | $55.00 | $65.00 | $3,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.07 / $16.07 / $29.32
| Facility | | $16.07 | $16.07 | $29.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.32 / $56.98 / $80.05
| Professional | | $32.32 | $56.98 | $80.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.88 / $50.00 / $112.04
| Facility | | $45.88 | $50.00 | $112.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.64 / $12.64 / $12.64
| Professional | | $12.64 | $12.64 | $12.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.64 / $12.64 / $12.64
| Professional | | $12.64 | $12.64 | $12.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.81 / $18.36 / $43.93
| Professional | | $11.81 | $18.36 | $43.93 |