- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.28 / $20.60 / $37.09
| Facility | | $7.28 | $20.60 | $37.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.28 / $7.28 / $15.27
| Professional | | $7.28 | $7.28 | $15.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.82 / $22.57 / $81.00
| Facility | | $10.82 | $22.57 | $81.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.70 / $11.87 / $24.79
| Professional | | $5.70 | $11.87 | $24.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.00 / $32.42 / $58.73
| Facility | | $14.00 | $32.42 | $58.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $11.16 / $11.75
| Professional | | $9.77 | $11.16 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.28 / $17.60 / $40.57
| Facility | | $8.28 | $17.60 | $40.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $11.10 / $19.89
| Professional | | $7.08 | $11.10 | $19.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.81 / $3,472.00 / $9,239.00
| Facility | | $34.81 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.27 / $17.27 / $20.32
| Professional | | $17.27 | $17.27 | $20.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.87 / $16.45 / $42.34
| Professional | | $11.87 | $16.45 | $42.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.57 / $81.00 / $81.00
| Facility | | $22.57 | $81.00 | $81.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $7.12 / $19.89
| Professional | | $5.25 | $7.12 | $19.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $7.12 / $47.07
| Professional | | $5.25 | $7.12 | $47.07 |