- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.56 / $26.69 / $48.65
| Facility | | $9.56 | $26.69 | $48.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.05 / $9.56 / $17.44
| Professional | | $9.05 | $9.56 | $17.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.38 / $22.10 / $70.00
| Facility | | $9.38 | $22.10 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.39 / $12.70 / $30.93
| Professional | | $6.39 | $12.70 | $30.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.00 / $28.67 / $50.13
| Facility | | $18.00 | $28.67 | $50.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.94 / $11.94 / $12.83
| Professional | | $11.94 | $11.94 | $12.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.86 / $15.86 / $34.26
| Facility | | $8.86 | $15.86 | $34.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $11.10 / $19.10
| Professional | | $7.41 | $11.10 | $19.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.45 / $3,472.00 / $9,239.00
| Facility | | $45.45 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $18.20 / $21.41
| Professional | | $18.20 | $18.20 | $21.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.70 / $17.60 / $40.89
| Professional | | $12.70 | $17.60 | $40.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.10 / $70.00 / $70.00
| Facility | | $22.10 | $70.00 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.20 / $12.70 / $21.18
| Professional | | $4.20 | $12.70 | $21.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.72 / $6.35 / $7.62
| Facility | | $5.72 | $6.35 | $7.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.20 / $12.70 / $21.18
| Professional | | $4.20 | $12.70 | $21.18 |