- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.66 / $51.54 / $108.14
| Facility | | $18.66 | $51.54 | $108.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.67 / $18.66 / $33.53
| Professional | | $17.67 | $18.66 | $33.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.87 / $34.10 / $100.00
| Facility | | $17.87 | $34.10 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.76 / $19.60 / $47.74
| Professional | | $11.76 | $19.60 | $47.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.47 / $54.88 / $95.95
| Facility | | $34.47 | $54.88 | $95.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.42 / $18.42 / $25.06
| Professional | | $18.42 | $18.42 | $25.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.70 / $29.09 / $66.92
| Facility | | $13.70 | $29.09 | $66.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.86 / $21.66 / $73.31
| Professional | | $11.86 | $21.66 | $73.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.46 / $28.46 / $33.49
| Professional | | $28.46 | $28.46 | $33.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.60 / $27.17 / $72.93
| Professional | | $19.60 | $27.17 | $72.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.53 / $22.89 / $23.07
| Facility | | $18.53 | $22.89 | $23.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.10 / $100.00 / $100.00
| Facility | | $34.10 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.41 / $13.14 / $41.36
| Professional | | $9.41 | $13.14 | $41.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.41 / $13.14 / $41.36
| Professional | | $9.41 | $13.14 | $41.36 |