- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.39 / $75.00 / $100.00
| Facility | | $12.39 | $75.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.49 / $17.55 / $244.00
| Professional | | $11.49 | $17.55 | $244.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.81 / $193.14 / $302.20
| Professional | | $20.81 | $193.14 | $302.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.02 / $19.02 / $91.98
| Facility | | $19.02 | $19.02 | $91.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.07 / $79.53 / $79.53
| Professional | | $19.07 | $79.53 | $79.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.61 / $34.88 / $332.00
| Facility | | $16.61 | $34.88 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.27 / $22.17 / $33.18
| Professional | | $18.27 | $22.17 | $33.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.19 / $23.42 / $37.61
| Professional | | $14.19 | $23.42 | $37.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.02 / $83.62 / $597.00
| Facility | | $19.02 | $83.62 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.07 / $22.86 / $79.53
| Professional | | $19.07 | $22.86 | $79.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $767.00 / $2,744.00 / $4,840.00
| Facility | | $767.00 | $2,744.00 | $4,840.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.45 / $17.78 / $52.13
| Professional | | $13.45 | $17.78 | $52.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.29 / $15.29 / $15.31
| Facility | | $15.29 | $15.29 | $15.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.29 / $15.31 / $33.71
| Professional | | $15.29 | $15.31 | $33.71 |