- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $25.12 / $46.77
| Facility | | $10.96 | $25.12 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.92 / $7.94 / $38.02
| Professional | | $6.92 | $7.94 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $12.59 / $100.00
| Facility | | $8.13 | $12.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $10.96 / $22.91
| Professional | | $5.25 | $10.96 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $22.39 / $35.48
| Facility | | $17.78 | $22.39 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $10.23 / $10.72
| Professional | | $10.23 | $10.23 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.76 / $14.45 / $32.36
| Facility | | $7.76 | $14.45 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $13.18 / $16.60
| Professional | | $6.46 | $13.18 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.30 / $3,630.78 / $9,772.37
| Facility | | $12.30 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $15.85 / $18.62
| Professional | | $15.85 | $15.85 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $10.96 / $25.70
| Professional | | $10.96 | $10.96 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.30 / $13.80 / $13.80
| Facility | | $12.30 | $13.80 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $12.59 / $100.00
| Facility | | $8.13 | $12.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $10.96 / $22.91
| Professional | | $5.25 | $10.96 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $10.96 / $14.13
| Facility | | $5.50 | $10.96 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $7.08 / $21.88
| Professional | | $5.25 | $7.08 | $21.88 |