- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $56.23 / $173.78
| Facility | | $25.70 | $56.23 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $16.98 / $54.95
| Professional | | $14.13 | $16.98 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.38 / $26.92 / $100.00
| Facility | | $17.38 | $26.92 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $19.05 / $39.81
| Professional | | $11.48 | $19.05 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $46.77 / $74.13
| Facility | | $37.15 | $46.77 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $17.78 / $24.55
| Professional | | $17.78 | $17.78 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.79 / $30.20 / $72.44
| Facility | | $14.79 | $30.20 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $22.91 / $32.36
| Professional | | $13.80 | $22.91 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $3,630.78 / $9,772.37
| Facility | | $19.50 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.54 / $27.54 / $32.36
| Professional | | $27.54 | $27.54 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $19.05 / $57.54
| Professional | | $19.05 | $19.05 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $28.18 / $134.90
| Facility | | $16.98 | $28.18 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.38 / $26.92 / $100.00
| Facility | | $17.38 | $26.92 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $19.05 / $39.81
| Professional | | $11.48 | $19.05 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $19.05 / $31.62
| Facility | | $10.96 | $19.05 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $15.85 / $45.71
| Professional | | $9.33 | $15.85 | $45.71 |