- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $37.15 / $95.50
| Facility | | $17.78 | $37.15 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $11.48 / $57.54
| Professional | | $8.32 | $11.48 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $18.20 / $100.00
| Facility | | $11.75 | $18.20 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $12.88 / $26.92
| Professional | | $7.76 | $12.88 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.12 / $31.62 / $50.12
| Facility | | $25.12 | $31.62 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $16.60
| Professional | | $12.02 | $12.02 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $20.42 / $50.12
| Facility | | $10.00 | $20.42 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $15.85 / $21.88
| Professional | | $9.33 | $15.85 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.62 / $3,630.78 / $9,772.37
| Facility | | $18.62 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.62 / $18.62 / $21.88
| Professional | | $18.62 | $18.62 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $12.88 / $38.90
| Professional | | $12.88 | $12.88 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.48 / $16.98 / $58.88
| Facility | | $11.48 | $16.98 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $18.20 / $100.00
| Facility | | $11.75 | $18.20 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $12.88 / $26.92
| Professional | | $7.76 | $12.88 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.41 / $12.88 / $21.38
| Facility | | $7.41 | $12.88 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $11.48 / $30.90
| Professional | | $6.46 | $11.48 | $30.90 |