- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $58.88 / $107.15
| Facility | | $19.50 | $58.88 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $10.96 / $57.54
| Professional | | $8.91 | $10.96 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $16.98 / $100.00
| Facility | | $10.96 | $16.98 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.24 / $12.02 / $25.70
| Professional | | $7.24 | $12.02 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.44 / $29.51 / $46.77
| Facility | | $23.44 | $29.51 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $11.48 / $15.49
| Professional | | $11.48 | $11.48 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $19.05 / $46.77
| Facility | | $9.33 | $19.05 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $14.79 / $20.42
| Professional | | $8.91 | $14.79 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $56.23 / $7,079.46
| Facility | | $14.45 | $56.23 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $16.22 / $21.88
| Professional | | $12.59 | $16.22 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $37.15
| Professional | | $12.02 | $12.02 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $18.20 / $173.78
| Facility | | $14.13 | $18.20 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $16.98 / $100.00
| Facility | | $10.96 | $16.98 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.24 / $12.02 / $25.70
| Professional | | $7.24 | $12.02 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $12.88 / $28.18
| Facility | | $10.72 | $12.88 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $12.59 / $18.20
| Professional | | $10.72 | $12.59 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.92 / $12.02 / $20.42
| Facility | | $6.92 | $12.02 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $10.23 / $28.84
| Professional | | $6.03 | $10.23 | $28.84 |