- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.13 / $38.90 / $64.57
| Facility | | $14.13 | $38.90 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $14.13 / $67.61
| Professional | | $10.96 | $14.13 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $21.38 / $100.00
| Facility | | $13.80 | $21.38 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $15.14 / $31.62
| Professional | | $8.91 | $15.14 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $36.31 / $58.88
| Facility | | $29.51 | $36.31 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $14.13 / $19.05
| Professional | | $14.13 | $14.13 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $23.99 / $57.54
| Facility | | $11.75 | $23.99 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $18.20 / $25.12
| Professional | | $10.96 | $18.20 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.38 / $3,630.78 / $9,772.37
| Facility | | $21.38 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.38 / $21.38 / $25.12
| Professional | | $21.38 | $21.38 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $15.14 / $45.71
| Professional | | $15.14 | $15.14 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $21.38 / $100.00
| Facility | | $13.80 | $21.38 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $15.14 / $31.62
| Professional | | $8.91 | $15.14 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.71 / $15.14 / $24.55
| Facility | | $8.71 | $15.14 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $12.59 / $35.48
| Professional | | $7.41 | $12.59 | $35.48 |