- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.03 / $30.42 / $57.40
| Facility | | $11.03 | $30.42 | $57.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.82 / $11.03 / $13.19
| Professional | | $9.82 | $11.03 | $13.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.56 / $22.57 / $100.00
| Facility | | $10.56 | $22.57 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.95 / $11.58 / $28.21
| Professional | | $6.95 | $11.58 | $28.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.57 / $32.76 / $57.28
| Facility | | $20.57 | $32.76 | $57.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.89 / $10.89 / $14.81
| Professional | | $10.89 | $10.89 | $14.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.09 / $17.19 / $39.54
| Facility | | $8.09 | $17.19 | $39.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.87 / $12.79 / $19.43
| Professional | | $6.87 | $12.79 | $19.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.56 / $3,472.00 / $9,239.00
| Facility | | $39.56 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.80 / $16.80 / $19.78
| Professional | | $16.80 | $16.80 | $19.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.58 / $16.05 / $43.08
| Professional | | $11.58 | $16.05 | $43.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.43 / $13.43 / $14.10
| Facility | | $13.43 | $13.43 | $14.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.57 / $100.00 / $100.00
| Facility | | $22.57 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.56 / $7.76 / $24.44
| Professional | | $5.56 | $7.76 | $24.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.21 / $6.95 / $7.96
| Facility | | $5.21 | $6.95 | $7.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.74 / $8.40 / $24.44
| Professional | | $5.74 | $8.40 | $24.44 |