- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.38 / $35.34 / $110.05
| Facility | | $16.38 | $35.34 | $110.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.39 / $11.52 / $12.29
| Professional | | $8.39 | $11.52 | $12.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.76 / $30.53 / $100.00
| Facility | | $11.76 | $30.53 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.74 / $12.90 / $31.42
| Professional | | $7.74 | $12.90 | $31.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.63 / $36.04 / $63.00
| Facility | | $22.63 | $36.04 | $63.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.13 / $12.13 / $16.50
| Professional | | $12.13 | $12.13 | $16.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.02 / $19.17 / $44.05
| Facility | | $9.02 | $19.17 | $44.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.70 / $14.26 / $21.69
| Professional | | $7.70 | $14.26 | $21.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.00 / $3,472.00 / $9,239.00
| Facility | | $53.00 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.67 / $18.67 / $21.97
| Professional | | $18.67 | $18.67 | $21.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.90 / $17.88 / $48.01
| Professional | | $12.90 | $17.88 | $48.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.83 / $15.71 / $39.36
| Facility | | $14.83 | $15.71 | $39.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.53 / $100.00 / $100.00
| Facility | | $30.53 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.19 / $8.64 / $27.21
| Professional | | $6.19 | $8.64 | $27.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.19 / $10.81 / $24.59
| Professional | | $6.19 | $10.81 | $24.59 |