- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.36 / $16.47 / $68.81
| Facility | | $10.36 | $16.47 | $68.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.03 / $11.91 / $14.15
| Professional | | $10.03 | $11.91 | $14.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.02 / $8.02 / $9.30
| Professional | | $8.02 | $8.02 | $9.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.03 / $21.38 / $24.30
| Professional | | $10.03 | $21.38 | $24.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.35 / $29.59 / $61.36
| Facility | | $9.35 | $29.59 | $61.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.58 / $11.03 / $19.10
| Professional | | $8.58 | $11.03 | $19.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.16 / $7.90 / $10.71
| Professional | | $6.16 | $7.90 | $10.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.36 / $13,785.00 / $13,785.00
| Facility | | $9.36 | $13,785.00 | $13,785.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $9.36 / $12.31
| Professional | | $9.36 | $9.36 | $12.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $8.02 / $19.84
| Professional | | $5.62 | $8.02 | $19.84 |