- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $30.90 / $67.61
| Facility | | $14.45 | $30.90 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $10.96 / $48.98
| Professional | | $8.91 | $10.96 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $16.60 / $100.00
| Facility | | $10.72 | $16.60 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $14.13 / $30.20
| Professional | | $8.71 | $14.13 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.91 / $28.84 / $45.71
| Facility | | $22.91 | $28.84 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $13.49 / $14.13
| Professional | | $13.49 | $13.49 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $18.62 / $41.69
| Facility | | $10.00 | $18.62 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $17.78 / $22.39
| Professional | | $8.32 | $17.78 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.23 / $3,630.78 / $9,772.37
| Facility | | $10.23 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.89 / $20.89 / $24.55
| Professional | | $20.89 | $20.89 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $33.88
| Professional | | $14.45 | $14.45 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $72.44 / $89.13
| Facility | | $72.44 | $72.44 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $16.60 / $100.00
| Facility | | $10.72 | $16.60 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $14.45 / $30.20
| Professional | | $8.71 | $14.45 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.24 / $14.45 / $18.20
| Facility | | $7.24 | $14.45 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.92 / $10.47 / $28.84
| Professional | | $6.92 | $10.47 | $28.84 |