- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.75 / $52.91 / $131.44
| Facility | | $18.75 | $52.91 | $131.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.72 / $16.35 / $17.86
| Professional | | $15.72 | $16.35 | $17.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.10 / $52.17 / $100.00
| Facility | | $17.10 | $52.17 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.25 / $18.75 / $45.67
| Professional | | $11.25 | $18.75 | $45.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.92 / $52.42 / $91.65
| Facility | | $32.92 | $52.42 | $91.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.63 / $17.63 / $23.99
| Professional | | $17.63 | $17.63 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.10 / $27.87 / $64.09
| Facility | | $13.10 | $27.87 | $64.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.24 / $20.74 / $31.64
| Professional | | $11.24 | $20.74 | $31.64 |
- 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
- $27.08 / $27.08 / $31.86
| Professional | | $27.08 | $27.08 | $31.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.75 / $25.99 / $69.78
| Professional | | $18.75 | $25.99 | $69.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.59 / $24.43 / $102.18
| Facility | | $17.59 | $24.43 | $102.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.15 / $100.00 / $100.00
| Facility | | $68.15 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.00 / $12.58 / $39.60
| Professional | | $9.00 | $12.58 | $39.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.00 / $13.65 / $35.74
| Professional | | $9.00 | $13.65 | $35.74 |