- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.27 / $32.57 / $133.84
| Facility | | $8.27 | $32.57 | $133.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.27 / $9.38 / $20.64
| Professional | | $8.27 | $9.38 | $20.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.46 / $24.64 / $70.00
| Facility | | $10.46 | $24.64 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.66 / $14.15 / $29.57
| Professional | | $5.66 | $14.15 | $29.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.92 / $31.95 / $55.85
| Facility | | $15.92 | $31.95 | $55.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.12 / $13.31 / $14.02
| Professional | | $11.12 | $13.31 | $14.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.61 / $17.30 / $35.56
| Facility | | $9.61 | $17.30 | $35.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $9.61 / $21.69
| Professional | | $7.59 | $9.61 | $21.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.14 / $3,472.00 / $9,239.00
| Facility | | $33.14 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.54 / $20.54 / $24.16
| Professional | | $20.54 | $20.54 | $24.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.16 / $19.63 / $45.60
| Professional | | $14.16 | $19.63 | $45.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.92 / $21.92 / $35.50
| Facility | | $21.92 | $21.92 | $35.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.64 / $70.00 / $70.00
| Facility | | $24.64 | $70.00 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $8.50 / $18.35
| Professional | | $5.25 | $8.50 | $18.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $8.50 / $56.15
| Professional | | $5.25 | $8.50 | $56.15 |