- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.79 / $30.56 / $330.00
| Facility | | $13.79 | $30.56 | $330.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.05 / $15.43 / $21.72
| Professional | | $13.05 | $15.43 | $21.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.58 / $20.20 / $32.17
| Professional | | $15.58 | $20.20 | $32.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.43 / $31.43 / $31.43
| Facility | | $31.43 | $31.43 | $31.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.43 / $31.43 / $31.91
| Professional | | $31.43 | $31.43 | $31.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.81 / $23.81 / $23.81
| Facility | | $23.81 | $23.81 | $23.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $26.42 / $71.45
| Professional | | $12.59 | $26.42 | $71.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $20.89 / $319.00
| Facility | | $20.89 | $20.89 | $319.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.87 / $45.00 / $55.00
| Professional | | $23.87 | $45.00 | $55.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.37 / $21.36 / $21.36
| Facility | | $20.37 | $21.36 | $21.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.82 / $27.08 / $46.22
| Professional | | $17.82 | $27.08 | $46.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.81 / $23.81 / $555.00
| Facility | | $23.81 | $23.81 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.37 / $28.56 / $66.22
| Professional | | $15.37 | $28.56 | $66.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.48 / $23.43 / $51.29
| Professional | | $17.48 | $23.43 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.37 / $23.52 / $23.52
| Facility | | $20.37 | $23.52 | $23.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.30 / $27.60 / $54.55
| Professional | | $20.30 | $27.60 | $54.55 |