- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.21 / $32.82 / $92.27
| Facility | | $15.21 | $32.82 | $92.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.38 / $10.91 / $13.06
| Professional | | $10.38 | $10.91 | $13.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.94 / $33.31 / $60.00
| Facility | | $10.94 | $33.31 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.19 / $11.98 / $29.18
| Professional | | $7.19 | $11.98 | $29.18 |
- 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
- $11.26 / $11.26 / $14.65
| Professional | | $11.26 | $11.26 | $14.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.38 / $17.84 / $40.99
| Facility | | $8.38 | $17.84 | $40.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.29 / $12.67 / $20.34
| Professional | | $7.29 | $12.67 | $20.34 |
- 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
- $17.27 / $17.27 / $20.32
| Professional | | $17.27 | $17.27 | $20.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.98 / $16.60 / $43.84
| Professional | | $11.98 | $16.60 | $43.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.99 / $60.26 / $162.36
| Facility | | $25.99 | $60.26 | $162.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.72 / $60.00 / $60.00
| Facility | | $36.72 | $60.00 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $8.03 / $24.18
| Professional | | $5.75 | $8.03 | $24.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $9.25 / $22.83
| Professional | | $5.75 | $9.25 | $22.83 |