- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.56 / $28.52 / $77.00
| Facility | | $11.56 | $28.52 | $77.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.00 / $10.09 / $18.35
| Professional | | $8.00 | $10.09 | $18.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.29 / $15.29 / $15.29
| Professional | | $15.29 | $15.29 | $15.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.28 / $48.01 / $87.15
| Facility | | $17.28 | $48.01 | $87.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $8.10 / $13.61
| Professional | | $5.00 | $8.10 | $13.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.29 / $23.70 / $70.98
| Facility | | $15.29 | $23.70 | $70.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.29 / $16.05 / $16.05
| Facility | | $15.29 | $16.05 | $16.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.68 / $27.79 / $65.09
| Facility | | $10.68 | $27.79 | $65.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.67 / $10.06 / $23.24
| Professional | | $7.67 | $10.06 | $23.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.63 / $80.00 / $80.00
| Facility | | $72.63 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.06 / $15.29 / $18.35
| Facility | | $12.06 | $15.29 | $18.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.37 / $15.29 / $15.29
| Professional | | $14.37 | $15.29 | $15.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.06 / $15.29 / $36.22
| Facility | | $12.06 | $15.29 | $36.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.73 / $11.77 / $17.32
| Professional | | $7.73 | $11.77 | $17.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.42 / $7.04 / $12.57
| Professional | | $6.42 | $7.04 | $12.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.12 / $6.12 / $15.29
| Professional | | $6.12 | $6.12 | $15.29 |