- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.62 / $47.86 / $93.33
| Facility | | $18.62 | $47.86 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $18.20 / $87.10
| Professional | | $14.13 | $18.20 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $27.54 / $100.00
| Facility | | $17.78 | $27.54 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $19.50 / $40.74
| Professional | | $11.48 | $19.50 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $46.77 / $75.86
| Facility | | $38.02 | $46.77 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $18.20 / $24.55
| Professional | | $18.20 | $18.20 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $30.90 / $74.13
| Facility | | $15.14 | $30.90 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $23.44 / $32.36
| Professional | | $14.13 | $23.44 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.54 / $3,630.78 / $9,772.37
| Facility | | $27.54 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $28.18 / $33.11
| Professional | | $28.18 | $28.18 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.50 / $19.50 / $58.88
| Professional | | $19.50 | $19.50 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $27.54 / $100.00
| Facility | | $17.78 | $27.54 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $19.50 / $40.74
| Professional | | $11.48 | $19.50 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $19.50 / $31.62
| Facility | | $10.96 | $19.50 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $16.98 / $45.71
| Professional | | $9.55 | $16.98 | $45.71 |