- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.55 / $63.20 / $131.87
| Facility | | $20.55 | $63.20 | $131.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.06 / $14.67 / $17.80
| Professional | | $14.06 | $14.67 | $17.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.76 / $28.15 / $100.00
| Facility | | $14.76 | $28.15 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.71 / $16.18 / $39.40
| Professional | | $9.71 | $16.18 | $39.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.30 / $45.06 / $78.78
| Facility | | $28.30 | $45.06 | $78.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.21 / $15.21 / $20.70
| Professional | | $15.21 | $15.21 | $20.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.30 / $24.04 / $55.30
| Facility | | $11.30 | $24.04 | $55.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $17.89 / $27.57
| Professional | | $9.77 | $17.89 | $27.57 |
- 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
- $23.34 / $23.34 / $27.46
| Professional | | $23.34 | $23.34 | $27.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.18 / $22.43 / $60.20
| Professional | | $16.18 | $22.43 | $60.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.77 / $21.08 / $131.38
| Facility | | $18.77 | $21.08 | $131.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.15 / $100.00 / $100.00
| Facility | | $28.15 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.77 / $10.85 / $34.14
| Professional | | $7.77 | $10.85 | $34.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.70 / $18.35 / $26.54
| Facility | | $15.70 | $18.35 | $26.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.27 / $16.68 / $20.46
| Professional | | $14.27 | $16.68 | $20.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.77 / $13.57 / $30.84
| Professional | | $7.77 | $13.57 | $30.84 |