- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $70.79 / $186.21
| Facility | | $25.70 | $70.79 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $13.49 / $60.26
| Professional | | $11.22 | $13.49 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $21.38 / $100.00
| Facility | | $13.80 | $21.38 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $15.14 / $35.48
| Professional | | $9.33 | $15.14 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $37.15 / $58.88
| Facility | | $29.51 | $37.15 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $14.13 / $19.05
| Professional | | $14.13 | $14.13 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $23.99 / $57.54
| Facility | | $11.75 | $23.99 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $11.75 / $63.10
| Professional | | $9.33 | $11.75 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $3,630.78 / $9,772.37
| Facility | | $21.88 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $21.88 / $25.70
| Professional | | $21.88 | $21.88 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $15.14 / $45.71
| Professional | | $15.14 | $15.14 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.62 / $20.89 / $131.83
| Facility | | $18.62 | $20.89 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $21.38 / $100.00
| Facility | | $13.80 | $21.38 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $15.14 / $35.48
| Professional | | $9.33 | $15.14 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.18 / $16.98 / $34.67
| Facility | | $13.18 | $16.98 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.18 / $15.49 / $22.39
| Professional | | $13.18 | $15.49 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.71 / $15.14 / $24.55
| Facility | | $8.71 | $15.14 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $15.14 / $38.02
| Professional | | $9.12 | $15.14 | $38.02 |