- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.50 / $36.81 / $65.75
| Facility | | $13.50 | $36.81 | $65.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.78 / $13.50 / $24.26
| Professional | | $12.78 | $13.50 | $24.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.93 / $26.92 / $100.00
| Facility | | $12.93 | $26.92 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.27 / $15.47 / $37.68
| Professional | | $9.27 | $15.47 | $37.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.21 / $40.14 / $70.18
| Facility | | $25.21 | $40.14 | $70.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.54 / $14.54 / $18.12
| Professional | | $14.54 | $14.54 | $18.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.81 / $21.13 / $48.41
| Facility | | $10.81 | $21.13 | $48.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $15.67 / $23.95
| Professional | | $9.36 | $15.67 | $23.95 |
- 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
- $22.40 / $22.40 / $26.35
| Professional | | $22.40 | $22.40 | $26.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.47 / $21.44 / $52.76
| Professional | | $15.47 | $21.44 | $52.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $100.00 / $100.00
| Facility | | $26.92 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.03 / $9.50 / $29.91
| Professional | | $7.03 | $9.50 | $29.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.92 / $15.47 / $18.55
| Facility | | $13.92 | $15.47 | $18.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.03 / $11.55 / $29.91
| Professional | | $7.03 | $11.55 | $29.91 |