- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $50.12 / $199.53
| Facility | | $16.98 | $50.12 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $15.49 / $61.66
| Professional | | $10.96 | $15.49 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.49 / $23.99 / $100.00
| Facility | | $15.49 | $23.99 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $16.98 / $35.48
| Professional | | $10.23 | $16.98 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.11 / $41.69 / $66.07
| Facility | | $33.11 | $41.69 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $15.85 / $21.88
| Professional | | $15.85 | $15.85 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.18 / $26.92 / $64.57
| Facility | | $13.18 | $26.92 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $20.42 / $28.18
| Professional | | $12.30 | $20.42 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.55 / $3,630.78 / $9,772.37
| Facility | | $24.55 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.55 / $24.55 / $28.84
| Professional | | $24.55 | $24.55 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $16.98 / $51.29
| Professional | | $16.98 | $16.98 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.95 / $21.88 / $100.00
| Facility | | $19.95 | $21.88 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.49 / $23.99 / $100.00
| Facility | | $15.49 | $23.99 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $16.98 / $35.48
| Professional | | $10.23 | $16.98 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $16.98 / $27.54
| Facility | | $9.77 | $16.98 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $14.79 / $40.74
| Professional | | $8.32 | $14.79 | $40.74 |