- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.26 / $34.26 / $160.27
| Facility | | $12.26 | $34.26 | $160.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.61 / $12.26 / $22.02
| Professional | | $11.61 | $12.26 | $22.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.74 / $22.39 / $100.00
| Facility | | $11.74 | $22.39 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.72 / $12.87 / $31.35
| Professional | | $7.72 | $12.87 | $31.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.63 / $36.04 / $63.00
| Facility | | $22.63 | $36.04 | $63.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.10 / $12.10 / $16.47
| Professional | | $12.10 | $12.10 | $16.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.00 / $19.11 / $43.98
| Facility | | $9.00 | $19.11 | $43.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.70 / $14.24 / $21.69
| Professional | | $7.70 | $14.24 | $21.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.08 / $3,472.00 / $9,239.00
| Facility | | $42.08 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.67 / $18.67 / $21.97
| Professional | | $18.67 | $18.67 | $21.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.87 / $17.84 / $47.90
| Professional | | $12.87 | $17.84 | $47.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.15 / $15.74 / $18.80
| Facility | | $15.15 | $15.74 | $18.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.39 / $100.00 / $100.00
| Facility | | $22.39 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.18 / $8.64 / $27.18
| Professional | | $6.18 | $8.64 | $27.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.18 / $10.78 / $24.53
| Professional | | $6.18 | $10.78 | $24.53 |