- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.55 / $27.97 / $37.88
| Facility | | $6.55 | $27.97 | $37.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.55 / $6.55 / $14.84
| Professional | | $6.55 | $6.55 | $14.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.36 / $21.63 / $70.00
| Facility | | $10.36 | $21.63 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.63 / $12.42 / $25.96
| Professional | | $5.63 | $12.42 | $25.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.34 / $33.79 / $55.85
| Facility | | $22.34 | $33.79 | $55.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.78 / $11.68 / $12.31
| Professional | | $8.78 | $11.68 | $12.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.17 / $16.97 / $38.81
| Facility | | $8.17 | $16.97 | $38.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.49 / $10.59 / $19.43
| Professional | | $7.49 | $10.59 | $19.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.78 / $3,472.00 / $9,239.00
| Facility | | $35.78 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.73 / $17.73 / $20.86
| Professional | | $17.73 | $17.73 | $20.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.43 / $17.23 / $40.64
| Professional | | $12.43 | $17.23 | $40.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.63 / $70.00 / $70.00
| Facility | | $21.63 | $70.00 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $7.46 / $19.04
| Professional | | $5.25 | $7.46 | $19.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.19 / $12.43 / $14.92
| Facility | | $11.19 | $12.43 | $14.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $7.46 / $20.32
| Professional | | $5.25 | $7.46 | $20.32 |