- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.55 / $18.27 / $33.32
| Facility | | $6.55 | $18.27 | $33.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.19 / $6.55 / $12.84
| Professional | | $6.19 | $6.55 | $12.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.91 / $16.27 / $100.00
| Facility | | $6.91 | $16.27 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.61 / $9.35 / $21.32
| Professional | | $5.61 | $9.35 | $21.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.37 / $21.29 / $37.22
| Facility | | $13.37 | $21.29 | $37.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.78 / $8.78 / $9.26
| Professional | | $8.78 | $8.78 | $9.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.52 / $11.43 / $23.48
| Facility | | $6.52 | $11.43 | $23.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $7.60 / $14.45
| Professional | | $5.05 | $7.60 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.82 / $3,472.00 / $9,239.00
| Facility | | $16.82 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.53 / $13.53 / $15.92
| Professional | | $13.53 | $13.53 | $15.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.35 / $12.96 / $30.11
| Professional | | $9.35 | $12.96 | $30.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.27 / $100.00 / $100.00
| Facility | | $16.27 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.74 / $5.61 / $14.51
| Professional | | $3.74 | $5.61 | $14.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.93 / $5.77 / $14.51
| Professional | | $3.93 | $5.77 | $14.51 |