- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.88 / $21.47 / $37.40
| Facility | | $7.88 | $21.47 | $37.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.46 / $7.88 / $14.15
| Professional | | $7.46 | $7.88 | $14.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.54 / $15.31 / $100.00
| Facility | | $7.54 | $15.31 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.28 / $8.80 / $21.44
| Professional | | $5.28 | $8.80 | $21.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.40 / $22.94 / $40.10
| Facility | | $14.40 | $22.94 | $40.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.27 / $8.27 / $10.58
| Professional | | $8.27 | $8.27 | $10.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.15 / $12.28 / $28.26
| Facility | | $6.15 | $12.28 | $28.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.20 / $9.14 / $14.01
| Professional | | $5.20 | $9.14 | $14.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.42 / $3,472.00 / $9,239.00
| Facility | | $37.42 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.61 / $12.61 / $14.83
| Professional | | $12.61 | $12.61 | $14.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.80 / $12.20 / $30.79
| Professional | | $8.80 | $12.20 | $30.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.31 / $100.00 / $100.00
| Facility | | $15.31 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.09 / $5.55 / $17.46
| Professional | | $4.09 | $5.55 | $17.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.09 / $6.94 / $16.77
| Professional | | $4.09 | $6.94 | $16.77 |