- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.19 / $33.24 / $62.10
| Facility | | $12.19 | $33.24 | $62.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.00 / $11.41 / $14.80
| Professional | | $11.00 | $11.41 | $14.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.67 / $26.11 / $100.00
| Facility | | $11.67 | $26.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.14 / $12.79 / $31.15
| Professional | | $6.14 | $12.79 | $31.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.63 / $36.04 / $63.00
| Facility | | $22.63 | $36.04 | $63.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $16.37
| Professional | | $12.02 | $12.02 | $16.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.94 / $19.01 / $43.75
| Facility | | $8.94 | $19.01 | $43.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.70 / $14.15 / $21.69
| Professional | | $7.70 | $14.15 | $21.69 |
- 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
- $18.67 / $18.67 / $21.97
| Professional | | $18.67 | $18.67 | $21.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.79 / $17.73 / $47.64
| Professional | | $12.79 | $17.73 | $47.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.51 / $16.05 / $16.67
| Facility | | $11.51 | $16.05 | $16.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.11 / $100.00 / $100.00
| Facility | | $26.11 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $7.67 / $27.02
| Professional | | $3.15 | $7.67 | $27.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $7.67 / $24.38
| Professional | | $3.15 | $7.67 | $24.38 |