- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.37 / $537.03 / $2,951.21
| Facility | | $5.37 | $537.03 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $15.85
| Professional | | $2.00 | $2.00 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.79 / $16.98 / $23.44
| Facility | | $14.79 | $16.98 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.36 / $14.13 / $20.89
| Professional | | $0.36 | $14.13 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.13 / $16.22 / $20.42
| Facility | | $5.13 | $16.22 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $39.81 / $77.62
| Professional | | $39.81 | $39.81 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.75 / $2.75 / $2.75
| Facility | | $2.75 | $2.75 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $2.75 / $2.75
| Professional | | $2.75 | $2.75 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.62 / $18.62 / $22.39
| Professional | | $18.62 | $18.62 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $19.05 / $32.36
| Professional | | $10.96 | $19.05 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,187.76
| Professional | | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $60.26
| Professional | | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $3.16 / $6.46
| Facility | | $2.57 | $3.16 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $2.75 / $5.62
| Professional | | $2.75 | $2.75 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $18.62 / $23.99
| Professional | | $14.13 | $18.62 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $21.88 / $21.88
| Facility | | $9.77 | $21.88 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.69 / $2.69 / $4.37
| Professional | | $2.69 | $2.69 | $4.37 |