- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.10 / $44.97 / $111.10
| Facility | | $16.10 | $44.97 | $111.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.71 / $16.10 / $23.88
| Professional | | $15.71 | $16.10 | $23.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.67 / $35.85 / $189.00
| Facility | | $16.67 | $35.85 | $189.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.77 / $18.28 / $44.53
| Professional | | $8.77 | $18.28 | $44.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.98 / $51.61 / $90.23
| Facility | | $30.98 | $51.61 | $90.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.18 / $17.18 / $21.62
| Professional | | $17.18 | $17.18 | $21.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.77 / $27.19 / $62.45
| Facility | | $12.77 | $27.19 | $62.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.03 / $18.69 / $30.73
| Professional | | $11.03 | $18.69 | $30.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.24 / $3,472.00 / $9,239.00
| Facility | | $50.24 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.60 / $26.60 / $31.30
| Professional | | $26.60 | $26.60 | $31.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.28 / $25.34 / $65.40
| Professional | | $18.28 | $25.34 | $65.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.24 / $90.24 / $90.24
| Facility | | $90.24 | $90.24 | $90.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.85 / $189.00 / $189.00
| Facility | | $35.85 | $189.00 | $189.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $10.97 / $35.69
| Professional | | $3.15 | $10.97 | $35.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $10.97 / $34.84
| Professional | | $3.15 | $10.97 | $34.84 |