- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $28.18 / $2,818.38
| Facility | | $7.94 | $28.18 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.98 / $12.02
| Professional | | $3.02 | $3.98 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.23 / $13.80 / $18.62
| Facility | | $10.23 | $13.80 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $6.31 / $11.22
| Professional | | $2.45 | $6.31 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.31 / $13.80 / $16.22
| Professional | | $6.31 | $13.80 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $6.31 / $24.55
| Facility | | $6.31 | $6.31 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $6.31 / $8.51
| Professional | | $5.25 | $6.31 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $6.31 / $12.02
| Facility | | $6.31 | $6.31 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.17 / $9.12 / $18.62
| Facility | | $6.17 | $9.12 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $6.92 / $79.43
| Professional | | $5.25 | $6.92 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,122.02 / $1,348.96
| Facility | | $676.08 | $1,122.02 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.89 / $5.37 / $7.59
| Professional | | $3.89 | $5.37 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,348.96 / $1,778.28
| Facility | | $1,096.48 | $1,348.96 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $2.69 / $7.59
| Professional | | $2.19 | $2.69 | $7.59 |