- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.28 / $58.00 / $203.15
| Facility | | $19.28 | $58.00 | $203.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.16 / $18.04 / $19.28
| Professional | | $13.16 | $18.04 | $19.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.46 / $35.22 / $109.00
| Facility | | $18.46 | $35.22 | $109.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.14 / $20.23 / $49.30
| Professional | | $12.14 | $20.23 | $49.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.50 / $56.53 / $98.83
| Facility | | $35.50 | $56.53 | $98.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.03 / $19.03 / $25.89
| Professional | | $19.03 | $19.03 | $25.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.14 / $30.04 / $69.14
| Facility | | $14.14 | $30.04 | $69.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.07 / $22.37 / $34.35
| Professional | | $12.07 | $22.37 | $34.35 |
- 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
- $29.40 / $29.40 / $34.59
| Professional | | $29.40 | $29.40 | $34.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.23 / $28.05 / $75.34
| Professional | | $20.23 | $28.05 | $75.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.83 / $26.47 / $283.58
| Facility | | $23.83 | $26.47 | $283.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.22 / $109.00 / $109.00
| Facility | | $35.22 | $109.00 | $109.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.72 / $13.57 / $42.72
| Professional | | $9.72 | $13.57 | $42.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.72 / $13.57 / $42.72
| Professional | | $9.72 | $13.57 | $42.72 |