- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.07 / $26.52 / $49.00
| Facility | | $8.07 | $26.52 | $49.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.07 / $9.90 / $20.65
| Professional | | $8.07 | $9.90 | $20.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.48 / $35.04 / $60.00
| Facility | | $13.48 | $35.04 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.92 / $11.53 / $28.08
| Professional | | $6.92 | $11.53 | $28.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.72 / $28.32 / $46.80
| Facility | | $18.72 | $28.32 | $46.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.84 / $10.84 / $11.41
| Professional | | $10.84 | $10.84 | $11.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.56 / $8.06 / $26.22
| Facility | | $7.56 | $8.06 | $26.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $14.04 / $21.74
| Professional | | $6.46 | $14.04 | $21.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.15 / $3,472.00 / $9,239.00
| Facility | | $38.15 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.80 / $16.80 / $19.78
| Professional | | $16.80 | $16.80 | $19.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.53 / $15.22 / $32.97
| Professional | | $11.53 | $15.22 | $32.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.93 / $14.40 / $408.41
| Facility | | $11.93 | $14.40 | $408.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.05 / $60.00 / $60.00
| Facility | | $20.05 | $60.00 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.61 / $6.92 / $20.18
| Professional | | $4.61 | $6.92 | $20.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.61 / $6.92 / $17.30
| Professional | | $4.61 | $6.92 | $17.30 |