- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.67 / $10.16 / $2,232.80
| Facility | | $4.67 | $10.16 | $2,232.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $5.97 / $15.38
| Professional | | $2.14 | $5.97 | $15.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.61 / $3.61 / $16.52
| Professional | | $3.61 | $3.61 | $16.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.39 / $9.02 / $9.02
| Facility | | $8.39 | $9.02 | $9.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $9.02 / $9.02
| Professional | | $9.02 | $9.02 | $9.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.61 / $12.61 / $12.61
| Facility | | $12.61 | $12.61 | $12.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.08 / $5.08 / $5.08
| Professional | | $5.08 | $5.08 | $5.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.76 / $19.69 / $332.00
| Facility | | $10.76 | $19.69 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.76 / $14.53 / $23.35
| Professional | | $10.76 | $14.53 | $23.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.24 / $6.53 / $6.53
| Facility | | $4.24 | $6.53 | $6.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.24 / $4.50 / $6.53
| Professional | | $4.24 | $4.50 | $6.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.61 / $12.61 / $597.00
| Facility | | $12.61 | $12.61 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.08 / $5.08 / $18.42
| Professional | | $5.08 | $5.08 | $18.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.58 / $6.24 / $11.71
| Professional | | $3.58 | $6.24 | $11.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.24 / $4.24 / $5.00
| Facility | | $4.24 | $4.24 | $5.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.24 / $4.50 / $6.53
| Professional | | $4.24 | $4.50 | $6.53 |