- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.80 / $29.65 / $97.20
| Facility | | $11.80 | $29.65 | $97.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.70 / $6.72 / $30.00
| Professional | | $5.70 | $6.72 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.36 / $14.98 / $60.00
| Facility | | $6.36 | $14.98 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.24 / $8.61 / $19.92
| Professional | | $4.24 | $8.61 | $19.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.35 / $19.66 / $34.38
| Facility | | $12.35 | $19.66 | $34.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.09 / $8.09 / $8.52
| Professional | | $8.09 | $8.09 | $8.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.01 / $10.53 / $21.64
| Facility | | $6.01 | $10.53 | $21.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.70 / $9.91 / $14.89
| Professional | | $4.70 | $9.91 | $14.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.63 / $3,472.00 / $9,239.00
| Facility | | $28.63 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.61 / $12.61 / $14.83
| Professional | | $12.61 | $12.61 | $14.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.61 / $11.93 / $27.72
| Professional | | $8.61 | $11.93 | $27.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.24 / $10.80 / $59.22
| Facility | | $8.24 | $10.80 | $59.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.98 / $60.00 / $60.00
| Facility | | $14.98 | $60.00 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $8.61 / $13.35
| Professional | | $3.15 | $8.61 | $13.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.52 / $9.11 / $16.02
| Facility | | $6.52 | $9.11 | $16.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.52 / $9.32 / $15.00
| Professional | | $6.52 | $9.32 | $15.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $8.61 / $11.36
| Professional | | $3.15 | $8.61 | $11.36 |