- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.73 / $37.28 / $136.88
| Facility | | $16.73 | $37.28 | $136.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.91 / $13.06 / $14.97
| Professional | | $10.91 | $13.06 | $14.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.94 / $23.68 / $80.00
| Facility | | $10.94 | $23.68 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.17 / $13.61 / $33.15
| Professional | | $8.17 | $13.61 | $33.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.09 / $33.59 / $58.73
| Facility | | $21.09 | $33.59 | $58.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.79 / $12.79 / $14.65
| Professional | | $12.79 | $12.79 | $14.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.51 / $18.59 / $40.99
| Facility | | $9.51 | $18.59 | $40.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.21 / $15.69 / $20.65
| Professional | | $7.21 | $15.69 | $20.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.78 / $3,472.00 / $9,239.00
| Facility | | $50.78 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.60 / $19.60 / $23.06
| Professional | | $19.60 | $19.60 | $23.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.61 / $18.86 / $44.62
| Professional | | $13.61 | $18.86 | $44.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.52 / $51.95 / $179.58
| Facility | | $29.52 | $51.95 | $179.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.68 / $80.00 / $80.00
| Facility | | $23.68 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.95 / $8.17 / $25.94
| Professional | | $5.95 | $8.17 | $25.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.95 / $9.61 / $25.94
| Professional | | $5.95 | $9.61 | $25.94 |