- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $53.70 / $97.72
| Facility | | $19.05 | $53.70 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $23.99 / $89.13
| Professional | | $19.05 | $23.99 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.39 / $33.88 / $100.00
| Facility | | $22.39 | $33.88 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $31.62 / $208.93
| Professional | | $16.98 | $31.62 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $58.88 / $85.11
| Facility | | $47.86 | $58.88 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $28.18 / $29.51
| Professional | | $25.70 | $28.18 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $40.74 / $77.62
| Facility | | $19.50 | $40.74 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.49 / $28.84 / $72.44
| Professional | | $15.49 | $28.84 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $3,630.78 / $9,772.37
| Facility | | $36.31 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $43.65 / $51.29
| Professional | | $43.65 | $43.65 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $61.66
| Professional | | $30.20 | $30.20 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.39 / $33.88 / $100.00
| Facility | | $22.39 | $33.88 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $31.62 / $208.93
| Professional | | $17.38 | $31.62 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $30.20 / $33.88
| Facility | | $18.20 | $30.20 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $28.18 / $57.54
| Professional | | $16.98 | $28.18 | $57.54 |