- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.94 / $98.04 / $133.44
| Facility | | $10.94 | $98.04 | $133.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.94 / $15.55 / $18.05
| Professional | | $10.94 | $15.55 | $18.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.05 / $12.10 / $19.71
| Professional | | $10.05 | $12.10 | $19.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.62 / $20.62 / $20.62
| Facility | | $20.62 | $20.62 | $20.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.62 / $20.62 / $20.62
| Professional | | $20.62 | $20.62 | $20.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.83 / $8.91 / $26.73
| Professional | | $7.83 | $8.91 | $26.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.73 / $55.00 / $332.00
| Facility | | $27.73 | $55.00 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.11 / $27.73 / $43.22
| Professional | | $23.11 | $27.73 | $43.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.37 / $14.53 / $32.25
| Professional | | $13.37 | $14.53 | $32.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.29 / $136.29 / $136.29
| Facility | | $136.29 | $136.29 | $136.29 |
- 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
- $7.91 / $25.00 / $35.60
| Professional | | $7.91 | $25.00 | $35.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.54 / $17.55 / $35.45
| Professional | | $11.54 | $17.55 | $35.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.48 / $16.48 / $88.77
| Facility | | $16.48 | $16.48 | $88.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.43 / $16.48 / $226.30
| Professional | | $12.43 | $16.48 | $226.30 |