- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $46.77 / $169.82
| Facility | | $20.89 | $46.77 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $13.80 / $100.00
| Professional | | $10.96 | $13.80 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $21.38 / $128.82
| Facility | | $14.13 | $21.38 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $15.49 / $46.77
| Professional | | $9.12 | $15.49 | $46.77 |
- 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
- $14.45 / $14.45 / $18.20
| Professional | | $14.45 | $14.45 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $24.55 / $58.88
| Facility | | $12.02 | $24.55 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $18.62 / $25.70
| Professional | | $11.22 | $18.62 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $3,630.78 / $9,772.37
| Facility | | $20.89 | $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
- $15.49 / $15.49 / $44.67
| Professional | | $15.49 | $15.49 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $31.62 / $199.53
| Facility | | $14.45 | $31.62 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $21.38 / $128.82
| Facility | | $14.13 | $21.38 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $15.49 / $46.77
| Professional | | $9.12 | $15.49 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.71 / $15.49 / $25.12
| Facility | | $8.71 | $15.49 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $13.80 / $46.77
| Professional | | $7.59 | $13.80 | $46.77 |