- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.63 / $53.73 / $142.08
| Facility | | $17.63 | $53.73 | $142.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.26 / $15.90 / $20.10
| Professional | | $15.26 | $15.90 | $20.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.07 / $31.86 / $100.00
| Facility | | $16.07 | $31.86 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.58 / $17.63 / $42.94
| Professional | | $10.58 | $17.63 | $42.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.86 / $49.15 / $85.93
| Facility | | $30.86 | $49.15 | $85.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.57 / $16.57 / $22.56
| Professional | | $16.57 | $16.57 | $22.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.32 / $26.21 / $60.27
| Facility | | $12.32 | $26.21 | $60.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.62 / $19.50 / $29.83
| Professional | | $10.62 | $19.50 | $29.83 |
- 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
- $25.68 / $25.68 / $30.21
| Professional | | $25.68 | $25.68 | $30.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.63 / $24.44 / $65.63
| Professional | | $17.63 | $24.44 | $65.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.86 / $22.98 / $65.68
| Facility | | $15.86 | $22.98 | $65.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.86 / $100.00 / $100.00
| Facility | | $31.86 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.46 / $11.83 / $37.22
| Professional | | $8.46 | $11.83 | $37.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.46 / $12.60 / $69.91
| Professional | | $8.46 | $12.60 | $69.91 |