- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.86 / $76.50 / $3,625.00
| Facility | | $22.86 | $76.50 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.68 / $16.76 / $20.05
| Professional | | $15.68 | $16.76 | $20.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.42 / $31.32 / $86.10
| Facility | | $16.42 | $31.32 | $86.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.80 / $18.00 / $43.84
| Professional | | $10.80 | $18.00 | $43.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.52 / $53.74 / $88.80
| Facility | | $35.52 | $53.74 | $88.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.58 / $26.74 / $61.49
| Facility | | $12.58 | $26.74 | $61.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.82 / $19.44 / $30.28
| Professional | | $10.82 | $19.44 | $30.28 |
- 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
- $26.14 / $26.14 / $30.75
| Professional | | $26.14 | $26.14 | $30.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.00 / $24.95 / $67.00
| Professional | | $18.00 | $24.95 | $67.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.18 / $16.18 / $16.18
| Facility | | $16.18 | $16.18 | $16.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.32 / $86.10 / $86.10
| Facility | | $31.32 | $86.10 | $86.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.64 / $12.07 / $37.13
| Professional | | $8.64 | $12.07 | $37.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.10 / $9.00 / $12.35
| Facility | | $8.10 | $9.00 | $12.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.64 / $13.90 / $34.31
| Professional | | $8.64 | $13.90 | $34.31 |