- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $43.65 / $165.96
| Facility | | $9.33 | $43.65 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $14.13 / $100.00
| Professional | | $10.47 | $14.13 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $9.33 / $10.47
| Professional | | $9.12 | $9.33 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.71 / $35.48 / $75.86
| Facility | | $8.71 | $35.48 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $12.88 / $42.66
| Professional | | $7.41 | $12.88 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $81.28 / $204.17
| Facility | | $33.88 | $81.28 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $17.38 / $43.65
| Professional | | $12.02 | $17.38 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $25.70 / $63.10
| Facility | | $10.00 | $25.70 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $15.14 / $25.12
| Professional | | $8.91 | $15.14 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $15.14 / $23.99
| Professional | | $13.49 | $15.14 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $15.14 / $33.88
| Professional | | $12.02 | $15.14 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $85.11 / $100.00
| Facility | | $85.11 | $85.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $18.20 / $18.20
| Professional | | $9.12 | $18.20 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $18.20 / $45.71
| Facility | | $12.59 | $18.20 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $14.13 / $33.88
| Professional | | $8.91 | $14.13 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $52.48 / $52.48
| Professional | | $52.48 | $52.48 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $15.49 / $25.70
| Professional | | $12.02 | $15.49 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.76 / $9.12 / $15.14
| Facility | | $6.76 | $9.12 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.31 / $9.12 / $30.20
| Professional | | $6.31 | $9.12 | $30.20 |