- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.30 / $22.88 / $42.25
| Facility | | $8.30 | $22.88 | $42.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.30 / $8.73 / $13.74
| Professional | | $8.30 | $8.73 | $13.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.13 / $20.80 / $130.03
| Facility | | $9.13 | $20.80 | $130.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.01 / $10.01 / $24.38
| Professional | | $6.01 | $10.01 | $24.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.95 / $27.86 / $48.70
| Facility | | $15.95 | $27.86 | $48.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.41 / $9.41 / $11.14
| Professional | | $9.41 | $9.41 | $11.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.00 / $14.88 / $34.19
| Facility | | $7.00 | $14.88 | $34.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.04 / $9.61 / $16.72
| Professional | | $6.04 | $9.61 | $16.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.40 / $3,472.00 / $9,239.00
| Facility | | $39.40 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.47 / $14.47 / $17.02
| Professional | | $14.47 | $14.47 | $17.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.01 / $13.87 / $35.70
| Professional | | $10.01 | $13.87 | $35.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $19.05 / $19.05
| Facility | | $19.05 | $19.05 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.80 / $130.03 / $130.03
| Facility | | $20.80 | $130.03 | $130.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.80 / $6.72 / $18.38
| Professional | | $4.80 | $6.72 | $18.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.80 / $7.30 / $18.38
| Professional | | $4.80 | $7.30 | $18.38 |