- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.07 / $32.90 / $53.85
| Facility | | $12.07 | $32.90 | $53.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.43 / $12.07 / $21.68
| Professional | | $11.43 | $12.07 | $21.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.56 / $32.31 / $100.00
| Facility | | $11.56 | $32.31 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.60 / $12.67 / $30.86
| Professional | | $7.60 | $12.67 | $30.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.12 / $35.22 / $61.58
| Facility | | $22.12 | $35.22 | $61.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.91 / $11.91 / $16.21
| Professional | | $11.91 | $11.91 | $16.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.85 / $18.80 / $43.29
| Facility | | $8.85 | $18.80 | $43.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.70 / $14.01 / $21.24
| Professional | | $7.70 | $14.01 | $21.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.39 / $3,472.00 / $9,239.00
| Facility | | $37.39 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $18.20 / $21.41
| Professional | | $18.20 | $18.20 | $21.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.67 / $17.55 / $47.17
| Professional | | $12.67 | $17.55 | $47.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.31 / $100.00 / $100.00
| Facility | | $32.31 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.08 / $8.50 / $26.75
| Professional | | $6.08 | $8.50 | $26.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.28 / $9.44 / $26.75
| Professional | | $6.28 | $9.44 | $26.75 |