- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.30 / $35.28 / $113.10
| Facility | | $9.30 | $35.28 | $113.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.30 / $11.62 / $57.55
| Professional | | $9.30 | $11.62 | $57.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $31.09 / $182.58
| Facility | | $11.75 | $31.09 | $182.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.18 / $12.88 / $30.29
| Professional | | $6.18 | $12.88 | $30.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.89 / $36.04 / $63.00
| Facility | | $17.89 | $36.04 | $63.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.11 / $12.11 / $12.75
| Professional | | $12.11 | $12.11 | $12.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.00 / $19.14 / $44.01
| Facility | | $9.00 | $19.14 | $44.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.70 / $11.85 / $21.69
| Professional | | $7.70 | $11.85 | $21.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.89 / $3,472.00 / $9,239.00
| Facility | | $32.89 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.67 / $18.67 / $21.97
| Professional | | $18.67 | $18.67 | $21.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $17.85 / $45.94
| Professional | | $12.88 | $17.85 | $45.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.72 / $15.16 / $392.97
| Facility | | $12.72 | $15.16 | $392.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.83 / $182.58 / $182.58
| Facility | | $39.83 | $182.58 | $182.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $7.73 / $21.60
| Professional | | $5.25 | $7.73 | $21.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.15 / $7.73 / $23.08
| Professional | | $5.15 | $7.73 | $23.08 |