- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.10 / $47.60 / $92.43
| Facility | | $20.10 | $47.60 | $92.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.79 / $11.16 / $12.92
| Professional | | $10.79 | $11.16 | $12.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.32 / $26.11 / $100.00
| Facility | | $11.32 | $26.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.30 / $12.41 / $30.23
| Professional | | $6.30 | $12.41 | $30.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.12 / $35.22 / $61.58
| Facility | | $22.12 | $35.22 | $61.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.67 / $11.67 / $15.88
| Professional | | $11.67 | $11.67 | $15.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.67 / $18.42 / $42.41
| Facility | | $8.67 | $18.42 | $42.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.49 / $13.72 / $20.79
| Professional | | $7.49 | $13.72 | $20.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.73 / $17.73 / $20.86
| Professional | | $17.73 | $17.73 | $20.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.41 / $17.20 / $46.20
| Professional | | $12.41 | $17.20 | $46.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.61 / $22.32 / $75.98
| Facility | | $14.61 | $22.32 | $75.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.11 / $100.00 / $100.00
| Facility | | $26.11 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.96 / $7.45 / $26.19
| Professional | | $5.96 | $7.45 | $26.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.49 / $17.37 / $31.42
| Facility | | $11.49 | $17.37 | $31.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.96 / $7.45 / $26.19
| Professional | | $5.96 | $7.45 | $26.19 |