- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $61.59 / $115.57
| Facility | | $10.47 | $61.59 | $115.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $23.92 / $24.28
| Professional | | $10.47 | $23.92 | $24.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.43 / $37.81 / $128.00
| Facility | | $24.43 | $37.81 | $128.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.85 / $23.62 / $55.92
| Professional | | $12.85 | $23.62 | $55.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.28 / $72.73 / $131.75
| Facility | | $21.28 | $72.73 | $131.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.06 / $25.17 / $26.51
| Professional | | $14.06 | $25.17 | $26.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.60 / $39.04 / $91.47
| Facility | | $17.60 | $39.04 | $91.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.16 / $24.97 / $45.20
| Professional | | $12.16 | $24.97 | $45.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.27 / $3,472.00 / $9,239.00
| Facility | | $50.27 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.75 / $38.75 / $45.58
| Professional | | $38.75 | $38.75 | $45.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.78 / $35.35 / $95.50
| Professional | | $26.78 | $35.35 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.32 / $31.63 / $34.56
| Facility | | $14.32 | $31.63 | $34.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.60 / $128.00 / $128.00
| Facility | | $46.60 | $128.00 | $128.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.22 / $16.07 / $44.89
| Professional | | $9.22 | $16.07 | $44.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.23 / $23.62 / $28.98
| Professional | | $11.23 | $23.62 | $28.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.22 / $16.07 / $44.89
| Professional | | $9.22 | $16.07 | $44.89 |