- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.72 / $65.76 / $862.10
| Facility | | $6.72 | $65.76 | $862.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $5.11 / $7.29
| Professional | | $5.05 | $5.11 | $7.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.02 / $17.07 / $34.09
| Facility | | $7.02 | $17.07 | $34.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.79 / $3.79 / $3.79
| Professional | | $3.79 | $3.79 | $3.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.00 / $31.66 / $412.34
| Facility | | $8.00 | $31.66 | $412.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $8.10 / $22.41
| Professional | | $5.05 | $8.10 | $22.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.21 / $37.21 / $37.21
| Facility | | $37.21 | $37.21 | $37.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.76 / $5.05 / $5.05
| Facility | | $4.76 | $5.05 | $5.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $5.05
| Professional | | $5.05 | $5.05 | $5.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $132.88 / $132.88
| Facility | | $75.00 | $132.88 | $132.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.11 / $7.24 / $86.74
| Facility | | $5.11 | $7.24 | $86.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.90 / $5.05 / $10.14
| Professional | | $3.90 | $5.05 | $10.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.76 / $5.05 / $9.40
| Facility | | $4.76 | $5.05 | $9.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.88 / $5.05 / $9.38
| Professional | | $4.88 | $5.05 | $9.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $57.79 / $57.79
| Professional | | $5.05 | $57.79 | $57.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.20 / $5.60 / $6.83
| Professional | | $5.20 | $5.60 | $6.83 |