- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $40.74 / $67.61
| Facility | | $14.13 | $40.74 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $14.13 / $70.79
| Professional | | $10.00 | $14.13 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $22.39 / $100.00
| Facility | | $14.45 | $22.39 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $15.85 / $33.11
| Professional | | $9.33 | $15.85 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $38.90 / $61.66
| Facility | | $30.90 | $38.90 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $14.79 / $19.95
| Professional | | $14.79 | $14.79 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.30 / $25.12 / $60.26
| Facility | | $12.30 | $25.12 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $19.05 / $26.92
| Professional | | $11.48 | $19.05 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $3,630.78 / $9,772.37
| Facility | | $21.88 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $26.92
| Professional | | $22.91 | $22.91 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $15.85 / $47.86
| Professional | | $15.85 | $15.85 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $22.39 / $100.00
| Facility | | $14.45 | $22.39 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $15.85 / $33.11
| Professional | | $9.33 | $15.85 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.12 / $15.85 / $25.70
| Facility | | $9.12 | $15.85 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $14.13 / $37.15
| Professional | | $7.76 | $14.13 | $37.15 |