- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.65 / $24.91 / $225.00
| Facility | | $9.65 | $24.91 | $225.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.57 / $10.24 / $12.05
| Professional | | $6.57 | $10.24 | $12.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.23 / $7.23 / $7.23
| Professional | | $7.23 | $7.23 | $7.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.20 / $29.06 / $293.00
| Facility | | $13.20 | $29.06 | $293.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.82 / $4.96 / $12.05
| Professional | | $4.82 | $4.96 | $12.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.62 / $66.28 / $112.07
| Facility | | $23.62 | $66.28 | $112.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.44 / $12.05 / $38.84
| Professional | | $8.44 | $12.05 | $38.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.92 / $15.82 / $53.79
| Facility | | $7.92 | $15.82 | $53.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.64 / $14.87 / $18.59
| Professional | | $8.64 | $14.87 | $18.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $12.05 / $99.00
| Professional | | $12.05 | $12.05 | $99.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.64 / $12.05 / $27.31
| Professional | | $9.64 | $12.05 | $27.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.69 / $60.00 / $60.00
| Facility | | $23.69 | $60.00 | $60.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.44 / $12.21 / $30.13
| Facility | | $8.44 | $12.21 | $30.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.64 / $12.05 / $14.46
| Professional | | $8.64 | $12.05 | $14.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.64 / $12.05 / $16.87
| Professional | | $9.64 | $12.05 | $16.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $18.44
| Professional | | $5.05 | $5.05 | $18.44 |