- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.91 / $55.76 / $140.82
| Facility | | $15.91 | $55.76 | $140.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.45 / $16.64 / $32.72
| Professional | | $12.45 | $16.64 | $32.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.28 / $12.08 / $12.91
| Professional | | $9.28 | $12.08 | $12.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.39 / $38.79 / $67.98
| Facility | | $10.39 | $38.79 | $67.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.76 / $15.66 / $22.31
| Professional | | $10.76 | $15.66 | $22.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.01 / $30.20 / $54.36
| Facility | | $13.01 | $30.20 | $54.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.87 / $21.06 / $28.40
| Professional | | $10.87 | $21.06 | $28.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.94 / $16.84 / $100.00
| Facility | | $13.94 | $16.84 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.80 / $10.91 / $17.12
| Professional | | $7.80 | $10.91 | $17.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.80 / $10.91 / $15.17
| Professional | | $7.80 | $10.91 | $15.17 |