- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.91 / $30.48 / $59.50
| Facility | | $10.91 | $30.48 | $59.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.71 / $10.81 / $13.06
| Professional | | $10.71 | $10.81 | $13.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.94 / $20.85 / $70.00
| Facility | | $10.94 | $20.85 | $70.00 |
- 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
- $52.38 / $3,472.00 / $9,239.00
| Facility | | $52.38 | $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
- $12.77 / $12.77 / $12.77
| Facility | | $12.77 | $12.77 | $12.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.85 / $70.00 / $70.00
| Facility | | $20.85 | $70.00 | $70.00 |
- 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 / $24.18
| Professional | | $5.75 | $9.25 | $24.18 |