- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.28 / $9.47 / $20.70
| Facility | | $5.28 | $9.47 | $20.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.04 / $13.12 / $26.06
| Professional | | $7.04 | $13.12 | $26.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $26.18 / $44.07
| Professional | | $18.20 | $26.18 | $44.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.72 / $12.72 / $4,050.00
| Facility | | $12.72 | $12.72 | $4,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.72 / $12.72 / $31.82
| Professional | | $12.72 | $12.72 | $31.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.66 / $11.66 / $11.66
| Facility | | $11.66 | $11.66 | $11.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.83 / $20.83 / $23.56
| Professional | | $20.83 | $20.83 | $23.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.90 / $13.55 / $332.00
| Facility | | $8.90 | $13.55 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.97 / $32.47 / $47.11
| Professional | | $25.97 | $32.47 | $47.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.61 / $21.71 / $27.58
| Facility | | $8.61 | $21.71 | $27.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.48 / $27.58 / $49.49
| Professional | | $17.48 | $27.58 | $49.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.38 / $55.38 / $55.38
| Professional | | $55.38 | $55.38 | $55.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.66 / $11.66 / $597.00
| Facility | | $11.66 | $11.66 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.83 / $24.06 / $50.35
| Professional | | $20.83 | $24.06 | $50.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.13 / $25.41 / $55.83
| Professional | | $19.13 | $25.41 | $55.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.48 / $9.48 / $27.58
| Facility | | $9.48 | $9.48 | $27.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.14 / $27.58 / $42.57
| Professional | | $16.14 | $27.58 | $42.57 |