- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.91 / $11.91 / $1,359.00
| Facility | | $11.91 | $11.91 | $1,359.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.16 / $11.88 / $21.89
| Professional | | $10.16 | $11.88 | $21.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.24 / $21.24 / $21.24
| Professional | | $21.24 | $21.24 | $21.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.26 / $11.68 / $21.54
| Professional | | $11.26 | $11.68 | $21.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $13.39 / $21.30
| Professional | | $10.60 | $13.39 | $21.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.11 / $17.11 / $17.11
| Professional | | $17.11 | $17.11 | $17.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.39 / $69.39 / $70.06
| Facility | | $69.39 | $69.39 | $70.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.91 / $11.91 / $1,812.00
| Facility | | $11.91 | $11.91 | $1,812.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.40 / $13.32 / $23.70
| Professional | | $10.40 | $13.32 | $23.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $13.73 / $20.29
| Professional | | $10.60 | $13.73 | $20.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.15 / $11.15 / $13.02
| Facility | | $11.15 | $11.15 | $13.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.92 / $11.15 / $13.02
| Professional | | $10.92 | $11.15 | $13.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.32 / $13.90 / $22.86
| Professional | | $10.32 | $13.90 | $22.86 |