- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.56 / $67.73 / $210.56
| Facility | | $15.56 | $67.73 | $210.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.41 / $13.55 / $26.70
| Professional | | $9.41 | $13.55 | $26.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $10.46 / $27.84
| Professional | | $9.02 | $10.46 | $27.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.80 / $30.74 / $100.00
| Facility | | $15.80 | $30.74 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.44 / $13.55 / $28.60
| Professional | | $7.44 | $13.55 | $28.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.42 / $30.81 / $63.15
| Facility | | $10.42 | $30.81 | $63.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.50 / $19.64 / $30.19
| Professional | | $10.50 | $19.64 | $30.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.71 / $14.52 / $15.97
| Professional | | $10.71 | $14.52 | $15.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.05 / $16.55 / $37.93
| Facility | | $15.05 | $16.55 | $37.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.05 / $22.58 / $41.39
| Facility | | $15.05 | $22.58 | $41.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.55 / $13.55 / $13.55
| Professional | | $13.55 | $13.55 | $13.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.30 / $24.83 / $41.39
| Facility | | $17.30 | $24.83 | $41.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.29 / $15.05 / $40.42
| Professional | | $11.29 | $15.05 | $40.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $9.60 / $21.03
| Professional | | $9.02 | $9.60 | $21.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.77 / $6.77 / $7.80
| Professional | | $6.77 | $6.77 | $7.80 |