- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.14 / $42.56 / $108.95
| Facility | | $19.14 | $42.56 | $108.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.56 / $13.15 / $14.36
| Professional | | $10.56 | $13.15 | $14.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.75 / $26.24 / $100.00
| Facility | | $13.75 | $26.24 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.35 / $15.08 / $36.72
| Professional | | $7.35 | $15.08 | $36.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.75 / $42.60 / $74.48
| Facility | | $26.75 | $42.60 | $74.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.18 / $14.18 / $19.28
| Professional | | $14.18 | $14.18 | $19.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.54 / $22.36 / $51.51
| Facility | | $10.54 | $22.36 | $51.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.16 / $16.66 / $25.31
| Professional | | $9.16 | $16.66 | $25.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.94 / $21.94 / $25.81
| Professional | | $21.94 | $21.94 | $25.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.08 / $20.90 / $56.11
| Professional | | $15.08 | $20.90 | $56.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.75 / $19.64 / $87.69
| Facility | | $17.75 | $19.64 | $87.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.24 / $100.00 / $100.00
| Facility | | $26.24 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.24 / $9.05 / $31.82
| Professional | | $7.24 | $9.05 | $31.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.24 / $9.05 / $28.74
| Professional | | $7.24 | $9.05 | $28.74 |