- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.03 / $14.32 / $78.45
| Professional | | $10.03 | $14.32 | $78.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.89 / $2.09 / $45.00
| Facility | | $1.89 | $2.09 | $45.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $22.99 / $41.27
| Professional | | $19.05 | $22.99 | $41.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.01 / $37.01 / $37.01
| Facility | | $37.01 | $37.01 | $37.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.70 / $19.27 / $29.67
| Professional | | $14.70 | $19.27 | $29.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.17 / $20.13 / $24.83
| Facility | | $18.17 | $20.13 | $24.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.11 / $17.11 / $42.66
| Professional | | $17.11 | $17.11 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.92 / $16.92 / $20.30
| Professional | | $16.92 | $16.92 | $20.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.76 / $21.88 / $42.20
| Professional | | $18.76 | $21.88 | $42.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $134.91 / $134.91
| Facility | | $75.00 | $134.91 | $134.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.41 / $20.13 / $31.24
| Facility | | $10.41 | $20.13 | $31.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.41 / $17.11 / $20.13
| Professional | | $10.41 | $17.11 | $20.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.32 / $51.32 / $51.32
| Professional | | $51.32 | $51.32 | $51.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.92 / $16.92 / $21.10
| Professional | | $16.92 | $16.92 | $21.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.42 / $14.44 / $24.12
| Professional | | $12.42 | $14.44 | $24.12 |