- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.26 / $34.26 / $122.22
| Facility | | $12.26 | $34.26 | $122.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.50 / $12.26 / $14.68
| Professional | | $11.50 | $12.26 | $14.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.74 / $35.79 / $169.00
| Facility | | $11.74 | $35.79 | $169.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.72 / $12.87 / $31.35
| Professional | | $7.72 | $12.87 | $31.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.20 / $38.13 / $63.00
| Facility | | $25.20 | $38.13 | $63.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.10 / $12.10 / $16.47
| Professional | | $12.10 | $12.10 | $16.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.00 / $19.11 / $43.98
| Facility | | $9.00 | $19.11 | $43.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.70 / $14.24 / $21.69
| Professional | | $7.70 | $14.24 | $21.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.67 / $18.67 / $21.97
| Professional | | $18.67 | $18.67 | $21.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.87 / $17.84 / $47.90
| Professional | | $12.87 | $17.84 | $47.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.07 / $15.74 / $181.47
| Facility | | $12.07 | $15.74 | $181.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.29 / $169.00 / $169.00
| Facility | | $36.29 | $169.00 | $169.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.18 / $8.64 / $27.18
| Professional | | $6.18 | $8.64 | $27.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.18 / $9.94 / $27.18
| Professional | | $6.18 | $9.94 | $27.18 |