- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.32 / $30.57 / $115.75
| Facility | | $11.32 | $30.57 | $115.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.99 / $10.42 / $11.32
| Professional | | $8.99 | $10.42 | $11.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.98 / $11.98 / $58.34
| Facility | | $11.98 | $11.98 | $58.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.92 / $5.92 / $7.24
| Professional | | $5.92 | $5.92 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.04 / $50.51 / $75.61
| Professional | | $33.04 | $50.51 | $75.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.38 / $30.63 / $62.07
| Facility | | $8.38 | $30.63 | $62.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.79 / $7.99 / $13.63
| Professional | | $6.79 | $7.99 | $13.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.38 / $14.98 / $17.73
| Professional | | $14.38 | $14.98 | $17.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.32 / $12.06 / $17.89
| Facility | | $11.32 | $12.06 | $17.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.02 / $20.46 / $30.00
| Professional | | $10.02 | $20.46 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.32 / $15.63 / $4,071.00
| Facility | | $9.32 | $15.63 | $4,071.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.32 / $15.63 / $4,071.00
| Professional | | $9.32 | $15.63 | $4,071.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.03 / $6.81 / $9.84
| Professional | | $5.03 | $6.81 | $9.84 |