- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $31.62 / $97.72
| Facility | | $10.47 | $31.62 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $6.76 / $28.84
| Professional | | $5.62 | $6.76 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.92 / $10.72 / $100.00
| Facility | | $6.92 | $10.72 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $7.59 / $15.85
| Professional | | $4.17 | $7.59 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.79 / $18.62 / $29.51
| Facility | | $14.79 | $18.62 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $7.08 / $9.55
| Professional | | $7.08 | $7.08 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $12.02 / $28.84
| Facility | | $5.89 | $12.02 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.37 / $9.12 / $15.14
| Professional | | $5.37 | $9.12 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.12 / $45.71 / $7,079.46
| Facility | | $9.12 | $45.71 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $10.00 / $13.49
| Professional | | $7.94 | $10.00 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $7.59 / $22.91
| Professional | | $7.59 | $7.59 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.12 / $44.67 / $109.65
| Facility | | $9.12 | $44.67 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.92 / $10.72 / $100.00
| Facility | | $6.92 | $10.72 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $7.59 / $15.85
| Professional | | $4.17 | $7.59 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.61 / $8.13 / $19.05
| Facility | | $6.61 | $8.13 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $7.76 / $11.22
| Professional | | $6.61 | $7.76 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.80 / $7.59 / $12.30
| Facility | | $3.80 | $7.59 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $6.31 / $17.78
| Professional | | $3.72 | $6.31 | $17.78 |