- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $79.43 / $263.03
| Facility | | $25.70 | $79.43 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $16.60 / $53.70
| Professional | | $13.80 | $16.60 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $26.30 / $100.00
| Facility | | $16.98 | $26.30 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $18.62 / $43.65
| Professional | | $7.76 | $18.62 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $44.67 / $72.44
| Facility | | $36.31 | $44.67 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $17.38 / $23.44
| Professional | | $17.38 | $17.38 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $29.51 / $70.79
| Facility | | $14.45 | $29.51 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $22.91 / $63.10
| Professional | | $13.49 | $22.91 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.39 / $79.43 / $7,079.46
| Facility | | $22.39 | $79.43 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.50 / $24.55 / $33.88
| Professional | | $19.50 | $24.55 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.62 / $18.62 / $56.23
| Professional | | $18.62 | $18.62 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.38 / $24.55 / $263.03
| Facility | | $21.38 | $24.55 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $26.30 / $100.00
| Facility | | $16.98 | $26.30 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $18.62 / $43.65
| Professional | | $8.91 | $18.62 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.22 / $22.39 / $40.74
| Facility | | $16.22 | $22.39 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.22 / $19.05 / $27.54
| Professional | | $16.22 | $19.05 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $18.62 / $30.90
| Facility | | $10.72 | $18.62 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $15.49 / $52.48
| Professional | | $5.25 | $15.49 | $52.48 |