- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.98 / $21.88 / $38.90
| Facility | | $3.98 | $21.88 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $10.00 / $23.44
| Professional | | $3.98 | $10.00 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $15.14 / $100.00
| Facility | | $9.77 | $15.14 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $11.75 / $27.54
| Professional | | $3.98 | $11.75 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.38 / $26.30 / $38.02
| Facility | | $21.38 | $26.30 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $12.59 / $13.18
| Professional | | $6.61 | $12.59 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.75 / $10.47 / $21.38
| Facility | | $5.75 | $10.47 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $15.14 / $19.95
| Professional | | $3.98 | $15.14 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $3,630.78 / $9,772.37
| Facility | | $9.33 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $19.05 / $22.39
| Professional | | $19.05 | $19.05 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $13.49 / $28.84
| Professional | | $13.49 | $13.49 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $15.14 / $100.00
| Facility | | $9.77 | $15.14 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $11.75 / $27.54
| Professional | | $3.98 | $11.75 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.37 / $8.71 / $13.49
| Facility | | $4.37 | $8.71 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $7.94 / $21.88
| Professional | | $3.16 | $7.94 | $21.88 |