- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $38.02 / $100.00
| Facility | | $12.59 | $38.02 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $11.48 / $23.99
| Professional | | $10.00 | $11.48 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $93.33 / $5,011.87
| Facility | | $70.79 | $93.33 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $10.23 / $12.59
| Professional | | $10.23 | $10.23 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $20.42 / $44.67
| Facility | | $8.91 | $20.42 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $14.79 / $23.44
| Professional | | $8.13 | $14.79 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $7.76 / $19.05
| Professional | | $5.25 | $7.76 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.18 / $13.18 / $13.18
| Facility | | $13.18 | $13.18 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.18 / $14.79 / $22.91
| Professional | | $13.18 | $14.79 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.44 / $35.48 / $120.23
| Facility | | $23.44 | $35.48 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $7.94 / $12.59
| Professional | | $7.94 | $7.94 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $36.31 / $87.10
| Facility | | $12.59 | $36.31 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $12.02 / $48.98
| Professional | | $9.77 | $12.02 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $17.38 / $19.95
| Facility | | $11.75 | $17.38 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $17.38 / $20.42
| Professional | | $11.75 | $17.38 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $13.18 / $15.85
| Facility | | $8.91 | $13.18 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $8.71 / $22.91
| Professional | | $6.03 | $8.71 | $22.91 |