- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.26 / $32.00 / $49.64
| Facility | | $12.26 | $32.00 | $49.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.26 / $15.85 / $24.62
| Professional | | $12.26 | $15.85 | $24.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $393.05 / $2,733.00
| Facility | | $28.84 | $393.05 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.25 / $30.52 / $297.00
| Professional | | $12.25 | $30.52 | $297.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.59 / $17.64 / $31.18
| Facility | | $13.59 | $17.64 | $31.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.30 / $27.13 / $45.45
| Professional | | $17.30 | $27.13 | $45.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.82 / $28.35 / $55.27
| Professional | | $16.82 | $28.35 | $55.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.02 / $168.26 / $6,679.00
| Facility | | $14.02 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.89 / $17.12 / $26.77
| Professional | | $8.89 | $17.12 | $26.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.12 / $31.33 / $44.88
| Professional | | $15.12 | $31.33 | $44.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.20 / $37.58 / $297.00
| Professional | | $21.20 | $37.58 | $297.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $3,445.00
| Facility | | $627.00 | $1,818.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.32 / $31.31 / $51.56
| Professional | | $20.32 | $31.31 | $51.56 |