- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $186.21 / $549.54
| Facility | | $1.00 | $186.21 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $1.00
| Professional | | $1.00 | $1.00 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.74 / $1.74 / $33.88
| Professional | | $1.74 | $1.74 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.74 / $69.18 / $112.20
| Facility | | $1.74 | $69.18 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.74 / $31.62 / $43.65
| Professional | | $1.74 | $31.62 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.62 / $2.00 / $25.70
| Facility | | $1.62 | $2.00 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $16.98 / $23.99
| Professional | | $16.60 | $16.98 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.62 / $2.04 / $26.30
| Facility | | $1.62 | $2.04 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.70 / $1.70 / $407.38
| Professional | | $1.70 | $1.70 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $54.95 / $85.11
| Professional | | $3.02 | $54.95 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.66 / $28.84 / $41.69
| Professional | | $0.66 | $28.84 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.74 / $1.74 / $89.13
| Facility | | $1.74 | $1.74 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.74 / $2.14 / $416.87
| Professional | | $1.74 | $2.14 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.54 / $27.54 / $27.54
| Professional | | $27.54 | $27.54 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $89.13 / $89.13
| Professional | | $2.45 | $89.13 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $10.72 / $10.72
| Facility | | $10.72 | $10.72 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.74 / $1.74 / $2.34
| Professional | | $1.74 | $1.74 | $2.34 |