- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.18 / $36.84 / $9,828.00
| Facility | | $11.18 | $36.84 | $9,828.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.54 / $10.65 / $31.27
| Professional | | $10.54 | $10.65 | $31.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.12 / $12.12 / $12.12
| Professional | | $12.12 | $12.12 | $12.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $11.44 / $8,459.92
| Facility | | $9.77 | $11.44 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.94 / $10.94 / $10.94
| Professional | | $10.94 | $10.94 | $10.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.94 / $10.54 / $10.54
| Facility | | $9.94 | $10.54 | $10.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.54 / $10.54 / $11.44
| Professional | | $10.54 | $10.54 | $11.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.54 / $10.54 / $14.50
| Professional | | $10.54 | $10.54 | $14.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.87 / $25.19 / $54.13
| Facility | | $17.87 | $25.19 | $54.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.80 / $14.80 / $15.33
| Professional | | $14.80 | $14.80 | $15.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.24 / $33.33 / $9,828.00
| Facility | | $12.24 | $33.33 | $9,828.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.54 / $12.12 / $34.85
| Professional | | $10.54 | $12.12 | $34.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.20 / $18.50 / $31.60
| Professional | | $15.20 | $18.50 | $31.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.94 / $10.54 / $10.54
| Facility | | $9.94 | $10.54 | $10.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.54 / $10.54 / $12.98
| Professional | | $10.54 | $10.54 | $12.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.98 / $11.98 / $13.90
| Facility | | $11.98 | $11.98 | $13.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.98 / $11.98 / $13.90
| Professional | | $11.98 | $11.98 | $13.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.54 / $11.17 / $15.39
| Professional | | $10.54 | $11.17 | $15.39 |