- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $25.42 / $91.74
| Facility | | $12.88 | $25.42 | $91.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.71 / $14.40 / $22.97
| Professional | | $10.71 | $14.40 | $22.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.90 / $43.91 / $100.00
| Facility | | $15.90 | $43.91 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.95 / $21.41 / $50.39
| Professional | | $15.95 | $21.41 | $50.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.28 / $188.76 / $243.78
| Facility | | $160.28 | $188.76 | $243.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $50.54 / $88.00
| Facility | | $13.80 | $50.54 | $88.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.16 / $54.94 / $115.68
| Professional | | $16.16 | $54.94 | $115.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.03 / $29.04 / $6,679.00
| Facility | | $18.03 | $29.04 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.96 / $17.04 / $28.85
| Professional | | $9.96 | $17.04 | $28.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.80 / $36.04 / $53.80
| Professional | | $18.80 | $36.04 | $53.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.46 / $18.59 / $210.58
| Facility | | $14.46 | $18.59 | $210.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $100.00 / $100.00
| Facility | | $80.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.16 / $20.49 / $154.06
| Professional | | $16.16 | $20.49 | $154.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.53 / $23.65 / $35.49
| Professional | | $14.53 | $23.65 | $35.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.95 / $20.07 / $48.15
| Professional | | $15.95 | $20.07 | $48.15 |