- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.02 / $86.46 / $198.90
| Facility | | $23.02 | $86.46 | $198.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.76 / $14.41 / $22.90
| Professional | | $11.76 | $14.41 | $22.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.33 / $29.23 / $100.00
| Facility | | $15.33 | $29.23 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $16.80 / $40.92
| Professional | | $9.44 | $16.80 | $40.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.83 / $47.50 / $83.05
| Facility | | $29.83 | $47.50 | $83.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.79 / $15.79 / $21.04
| Professional | | $15.79 | $15.79 | $21.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.74 / $24.94 / $57.44
| Facility | | $11.74 | $24.94 | $57.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.19 / $19.41 / $62.05
| Professional | | $10.19 | $19.41 | $62.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.98 / $83.43 / $6,679.00
| Facility | | $19.98 | $83.43 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.14 / $22.13 / $28.56
| Professional | | $17.14 | $22.13 | $28.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.80 / $23.28 / $66.81
| Professional | | $16.80 | $23.28 | $66.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.55 / $21.90 / $239.44
| Facility | | $18.55 | $21.90 | $239.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.23 / $100.00 / $100.00
| Facility | | $29.23 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.06 / $10.08 / $35.46
| Professional | | $8.06 | $10.08 | $35.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.30 / $19.10 / $37.35
| Facility | | $16.30 | $19.10 | $37.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.56 / $18.18 / $25.20
| Professional | | $15.56 | $18.18 | $25.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.00 / $60.00 / $60.00
| Facility | | $60.00 | $60.00 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.06 / $10.08 / $35.46
| Professional | | $8.06 | $10.08 | $35.46 |