- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.06 / $41.81 / $174.59
| Facility | | $13.06 | $41.81 | $174.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.21 / $12.34 / $13.06
| Professional | | $12.21 | $12.34 | $13.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.52 / $29.65 / $222.00
| Facility | | $12.52 | $29.65 | $222.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.59 / $13.72 / $33.42
| Professional | | $6.59 | $13.72 | $33.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.17 / $38.50 / $67.30
| Facility | | $24.17 | $38.50 | $67.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.90 / $12.90 / $17.54
| Professional | | $12.90 | $12.90 | $17.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.59 / $20.38 / $46.84
| Facility | | $9.59 | $20.38 | $46.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.33 / $15.15 / $23.05
| Professional | | $8.33 | $15.15 | $23.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.46 / $3,472.00 / $9,239.00
| Facility | | $38.46 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.60 / $19.60 / $23.06
| Professional | | $19.60 | $19.60 | $23.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.72 / $19.02 / $51.05
| Professional | | $13.72 | $19.02 | $51.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.77 / $17.88 / $311.20
| Facility | | $15.77 | $17.88 | $311.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.65 / $222.00 / $222.00
| Facility | | $29.65 | $222.00 | $222.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $8.23 / $28.94
| Professional | | $5.25 | $8.23 | $28.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.35 / $13.72 / $16.46
| Facility | | $12.35 | $13.72 | $16.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $8.23 / $26.15
| Professional | | $5.25 | $8.23 | $26.15 |