- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.94 / $35.00 / $119.78
| Facility | | $10.94 | $35.00 | $119.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.42 / $11.52 / $23.18
| Professional | | $10.42 | $11.52 | $23.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.08 / $37.77 / $8,639.91
| Facility | | $29.08 | $37.77 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.03 / $10.03 / $10.03
| Professional | | $10.03 | $10.03 | $10.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.46 / $17.14 / $42.38
| Facility | | $8.46 | $17.14 | $42.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.08 / $14.87 / $22.43
| Professional | | $8.08 | $14.87 | $22.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.92 / $10.30 / $17.43
| Professional | | $5.92 | $10.30 | $17.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.91 / $38.75 / $110.48
| Facility | | $25.91 | $38.75 | $110.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $5.50 / $7.72
| Professional | | $5.50 | $5.50 | $7.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.10 / $35.00 / $119.78
| Facility | | $13.10 | $35.00 | $119.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.65 / $11.59 / $53.15
| Professional | | $9.65 | $11.59 | $53.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.61 / $19.55 / $42.38
| Facility | | $8.61 | $19.55 | $42.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.08 / $14.87 / $22.43
| Professional | | $8.08 | $14.87 | $22.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.87 / $12.87 / $12.87
| Facility | | $12.87 | $12.87 | $12.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.21 / $12.87 / $12.87
| Professional | | $8.21 | $12.87 | $12.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.30 / $7.72 / $19.30
| Professional | | $4.30 | $7.72 | $19.30 |