- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.81 / $53.53 / $165.12
| Facility | | $31.81 | $53.53 | $165.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.03 / $16.95 / $21.94
| Professional | | $14.03 | $16.95 | $21.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.30 / $35.85 / $100.00
| Facility | | $17.30 | $35.85 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.38 / $18.97 / $46.21
| Professional | | $11.38 | $18.97 | $46.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.43 / $53.24 / $93.08
| Facility | | $33.43 | $53.24 | $93.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.82 / $17.82 / $24.27
| Professional | | $17.82 | $17.82 | $24.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.25 / $28.15 / $64.81
| Facility | | $13.25 | $28.15 | $64.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.45 / $20.98 / $32.09
| Professional | | $11.45 | $20.98 | $32.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.54 / $27.54 / $32.40
| Professional | | $27.54 | $27.54 | $32.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.97 / $26.29 / $70.62
| Professional | | $18.97 | $26.29 | $70.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.01 / $24.82 / $133.66
| Facility | | $22.01 | $24.82 | $133.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.85 / $100.00 / $100.00
| Facility | | $35.85 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.11 / $11.55 / $40.04
| Professional | | $9.11 | $11.55 | $40.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.11 / $11.38 / $36.15
| Professional | | $9.11 | $11.38 | $36.15 |