- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $89.70 / $422.62
| Facility | | $10.00 | $89.70 | $422.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.75 / $10.00 / $48.57
| Professional | | $9.75 | $10.00 | $48.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.21 / $18.89 / $37.90
| Professional | | $15.21 | $18.89 | $37.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.68 / $23.68 / $23.68
| Facility | | $23.68 | $23.68 | $23.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.68 / $23.68 / $23.68
| Professional | | $23.68 | $23.68 | $23.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.94 / $26.94 / $162.13
| Professional | | $26.94 | $26.94 | $162.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.00 / $42.33 / $332.00
| Facility | | $5.00 | $42.33 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.17 / $58.61 / $108.89
| Professional | | $39.17 | $58.61 | $108.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.48 / $22.71 / $43.66
| Professional | | $19.48 | $22.71 | $43.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.86 / $40.86 / $49.42
| Facility | | $40.86 | $40.86 | $49.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $597.00 / $74,999.25
| Facility | | $555.00 | $597.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.84 / $5.84 / $26.94
| Professional | | $5.84 | $5.84 | $26.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.55 / $18.82 / $46.15
| Professional | | $12.55 | $18.82 | $46.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.16 / $22.16 / $22.22
| Facility | | $22.16 | $22.16 | $22.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.82 / $22.22 / $43.66
| Professional | | $16.82 | $22.22 | $43.66 |