- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.81 / $108.00 / $108.00
| Facility | | $14.81 | $108.00 | $108.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.66 / $14.51 / $18.07
| Professional | | $11.66 | $14.51 | $18.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.36 / $3.53 / $3.53
| Professional | | $3.36 | $3.53 | $3.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.71 / $12.71 / $12.71
| Professional | | $12.71 | $12.71 | $12.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $8.00 / $15.00
| Professional | | $4.00 | $8.00 | $15.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.56 / $40.56 / $40.56
| Facility | | $40.56 | $40.56 | $40.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.55 / $11.00 / $17.00
| Professional | | $4.55 | $11.00 | $17.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.00 / $70.00 / $80.00
| Facility | | $70.00 | $70.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.00 / $41.00 / $41.00
| Professional | | $41.00 | $41.00 | $41.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.01 / $14.22 / $18.23
| Facility | | $4.01 | $14.22 | $18.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.25 / $6.46 / $10.00
| Professional | | $6.25 | $6.46 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.77 / $9.71 / $10.90
| Professional | | $7.77 | $9.71 | $10.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.17 / $14.81 / $18.23
| Facility | | $4.17 | $14.81 | $18.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.43 / $10.19 / $15.97
| Professional | | $4.43 | $10.19 | $15.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.79 / $5.30 / $8.82
| Professional | | $3.79 | $5.30 | $8.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.37 / $6.01 / $7.50
| Professional | | $4.37 | $6.01 | $7.50 |