- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $43.65 / $95.50
| Facility | | $20.89 | $43.65 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $11.48 / $56.23
| Professional | | $8.91 | $11.48 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.48 / $17.78 / $100.00
| Facility | | $11.48 | $17.78 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $12.59 / $26.30
| Professional | | $7.59 | $12.59 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.55 / $30.90 / $48.98
| Facility | | $24.55 | $30.90 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $11.75 / $16.22
| Professional | | $11.75 | $11.75 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $19.95 / $48.98
| Facility | | $9.77 | $19.95 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $15.14 / $21.38
| Professional | | $9.12 | $15.14 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $3,630.78 / $9,772.37
| Facility | | $18.20 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $18.20 / $21.38
| Professional | | $18.20 | $18.20 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $12.59 / $38.02
| Professional | | $12.59 | $12.59 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.79 / $17.38 / $79.43
| Facility | | $14.79 | $17.38 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.48 / $17.78 / $100.00
| Facility | | $11.48 | $17.78 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $12.59 / $26.30
| Professional | | $7.59 | $12.59 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $14.13 / $20.89
| Facility | | $10.96 | $14.13 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $12.88 / $19.05
| Professional | | $10.96 | $12.88 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.24 / $12.59 / $20.89
| Facility | | $7.24 | $12.59 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.31 / $10.96 / $30.20
| Professional | | $6.31 | $10.96 | $30.20 |