- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.14 / $22.55 / $59.36
| Facility | | $9.14 | $22.55 | $59.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.77 / $8.69 / $15.17
| Professional | | $6.77 | $8.69 | $15.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $14.87 / $16.93
| Professional | | $5.00 | $14.87 | $16.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.09 / $12.09 / $80.00
| Facility | | $12.09 | $12.09 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.79 / $25.31 / $54.36
| Facility | | $11.79 | $25.31 | $54.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.14 / $7.76 / $22.02
| Professional | | $6.14 | $7.76 | $22.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.82 / $195.50 / $246.00
| Facility | | $93.82 | $195.50 | $246.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424.00 / $424.00 / $424.00
| Professional | | $424.00 | $424.00 | $424.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.43 / $14.87 / $28.60
| Facility | | $9.43 | $14.87 | $28.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.78 / $12.09 / $15.11
| Professional | | $11.78 | $12.09 | $15.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.86 / $14.51 / $27.20
| Professional | | $7.86 | $14.51 | $27.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.43 / $16.27 / $52.33
| Facility | | $9.43 | $16.27 | $52.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.23 / $11.59 / $21.16
| Professional | | $6.23 | $11.59 | $21.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $8.42 / $22.97
| Professional | | $7.25 | $8.42 | $22.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.72 / $6.26 / $12.09
| Professional | | $5.72 | $6.26 | $12.09 |