- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.18 / $41.69 / $107.15
| Facility | | $13.18 | $41.69 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $12.88 / $30.20
| Professional | | $10.96 | $12.88 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $109.65 / $5,011.87
| Facility | | $81.28 | $109.65 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $13.49
| Professional | | $12.02 | $12.02 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $23.99 / $52.48
| Facility | | $10.47 | $23.99 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $17.78 / $26.92
| Professional | | $9.55 | $17.78 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.24 / $15.49 / $22.39
| Professional | | $7.24 | $15.49 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.49 / $15.49 / $15.49
| Facility | | $15.49 | $15.49 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $17.38 / $26.92
| Professional | | $15.14 | $17.38 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.30 / $41.69 / $100.00
| Facility | | $26.30 | $41.69 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $9.33 / $11.75
| Professional | | $9.33 | $9.33 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.18 / $41.69 / $141.25
| Facility | | $13.18 | $41.69 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $14.13 / $57.54
| Professional | | $10.96 | $14.13 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.49 / $16.60 / $33.88
| Facility | | $15.49 | $16.60 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $16.60 / $46.77
| Professional | | $10.23 | $16.60 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $15.49 / $18.62
| Facility | | $10.47 | $15.49 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $10.00 / $26.92
| Professional | | $6.46 | $10.00 | $26.92 |