- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.98 / $26.52 / $49.00
| Facility | | $10.98 | $26.52 | $49.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.94 / $10.26 / $10.98
| Professional | | $9.94 | $10.26 | $10.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.51 / $20.05 / $90.00
| Facility | | $10.51 | $20.05 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.53 / $11.53 / $28.08
| Professional | | $5.53 | $11.53 | $28.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.05 / $31.95 / $55.85
| Facility | | $20.05 | $31.95 | $55.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.84 / $10.84 / $14.75
| Professional | | $10.84 | $10.84 | $14.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.06 / $17.10 / $39.39
| Facility | | $8.06 | $17.10 | $39.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.87 / $12.74 / $19.43
| Professional | | $6.87 | $12.74 | $19.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.67 / $3,472.00 / $9,239.00
| Facility | | $52.67 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.80 / $16.80 / $19.78
| Professional | | $16.80 | $16.80 | $19.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.53 / $15.98 / $42.91
| Professional | | $11.53 | $15.98 | $42.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.36 / $10.36 / $10.36
| Facility | | $10.36 | $10.36 | $10.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.05 / $90.00 / $90.00
| Facility | | $20.05 | $90.00 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $6.92 / $24.33
| Professional | | $3.15 | $6.92 | $24.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $6.92 / $21.98
| Professional | | $3.15 | $6.92 | $21.98 |