- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.10 / $122.02 / $123.70
| Facility | | $9.10 | $122.02 | $123.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.10 / $11.32 / $14.98
| Professional | | $9.10 | $11.32 | $14.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.03 / $9.88 / $15.78
| Professional | | $8.03 | $9.88 | $15.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.86 / $16.86 / $16.86
| Facility | | $16.86 | $16.86 | $16.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.86 / $16.86 / $16.86
| Professional | | $16.86 | $16.86 | $16.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.89 / $6.93 / $20.60
| Professional | | $5.89 | $6.93 | $20.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.82 / $34.46 / $332.00
| Facility | | $18.82 | $34.46 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.82 / $22.60 / $35.21
| Professional | | $18.82 | $22.60 | $35.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.40 / $11.79 / $26.06
| Professional | | $10.40 | $11.79 | $26.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.89 / $22.89 / $22.89
| Facility | | $22.89 | $22.89 | $22.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $597.00 / $74,999.25
| Facility | | $555.00 | $597.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.57 / $12.00 / $28.10
| Professional | | $6.57 | $12.00 | $28.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.65 / $14.10 / $26.89
| Professional | | $9.65 | $14.10 | $26.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.32 / $13.32 / $61.19
| Facility | | $13.32 | $13.32 | $61.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.05 / $13.32 / $149.28
| Professional | | $10.05 | $13.32 | $149.28 |