- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.89 / $33.21 / $60.57
| Facility | | $11.89 | $33.21 | $60.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.14 / $11.89 / $24.92
| Professional | | $3.14 | $11.89 | $24.92 |
- 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
- $10.08 / $16.80 / $38.72
| Professional | | $10.08 | $16.80 | $38.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.72 / $47.50 / $83.05
| Facility | | $24.72 | $47.50 | $83.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.79 / $15.79 / $16.63
| Professional | | $15.79 | $15.79 | $16.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.74 / $21.74 / $42.64
| Facility | | $11.74 | $21.74 | $42.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $13.79 / $25.81
| Professional | | $9.02 | $13.79 | $25.81 |
- 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
- $24.28 / $24.28 / $28.56
| Professional | | $24.28 | $24.28 | $28.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.80 / $23.28 / $59.93
| Professional | | $16.80 | $23.28 | $59.93 |
- 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
- $6.72 / $10.08 / $26.34
| Professional | | $6.72 | $10.08 | $26.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.12 / $16.80 / $20.16
| Facility | | $15.12 | $16.80 | $20.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.06 / $10.46 / $22.34
| Professional | | $7.06 | $10.46 | $22.34 |