- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.00 / $19.44 / $6,177.32
| Facility | | $12.00 | $19.44 | $6,177.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.07 / $12.18 / $2,252.67
| Professional | | $12.07 | $12.18 | $2,252.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.66 / $9.66 / $12.07
| Facility | | $9.66 | $9.66 | $12.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.37 / $12.07 / $12.07
| Professional | | $10.37 | $12.07 | $12.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $9.33 / $9.80
| Facility | | $9.33 | $9.33 | $9.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $9.33 / $9.33
| Professional | | $9.33 | $9.33 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.53 / $11.39 / $12.07
| Facility | | $9.53 | $11.39 | $12.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.07 / $12.07 / $12.07
| Professional | | $12.07 | $12.07 | $12.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.39 / $17.09 / $332.00
| Facility | | $11.39 | $17.09 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.09 / $13.09 / $15.92
| Professional | | $13.09 | $13.09 | $15.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.07 / $12.07 / $12.30
| Facility | | $12.07 | $12.07 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.07 / $12.07 / $12.30
| Professional | | $12.07 | $12.07 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.18 / $8.18 / $8.32
| Facility | | $8.18 | $8.18 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.53 / $11.39 / $555.00
| Facility | | $9.53 | $11.39 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.49 / $12.07 / $15.56
| Professional | | $11.49 | $12.07 | $15.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.07 / $12.07 / $15.56
| Professional | | $12.07 | $12.07 | $15.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.30 / $12.30 / $12.30
| Facility | | $12.30 | $12.30 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.07 / $12.07 / $12.30
| Professional | | $12.07 | $12.07 | $12.30 |