- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.28 / $20.32 / $44.67
| Facility | | $7.28 | $20.32 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.28 / $7.28 / $15.27
| Professional | | $7.28 | $7.28 | $15.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.75 / $18.29 / $70.00
| Facility | | $8.75 | $18.29 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.31 / $10.51 / $23.73
| Professional | | $6.31 | $10.51 | $23.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.78 / $27.03 / $47.25
| Facility | | $14.78 | $27.03 | $47.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $9.88 / $10.40
| Professional | | $9.77 | $9.88 | $10.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.34 / $14.34 / $32.77
| Facility | | $7.34 | $14.34 | $32.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.24 / $8.83 / $16.27
| Professional | | $6.24 | $8.83 | $16.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.93 / $3,472.00 / $9,239.00
| Facility | | $34.93 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.93 / $14.93 / $17.57
| Professional | | $14.93 | $14.93 | $17.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.51 / $14.57 / $34.33
| Professional | | $10.51 | $14.57 | $34.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.29 / $70.00 / $70.00
| Facility | | $18.29 | $70.00 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.75 / $6.41 / $19.80
| Professional | | $4.75 | $6.41 | $19.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.20 / $6.31 / $19.80
| Professional | | $4.20 | $6.31 | $19.80 |