- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.20 / $33.24 / $54.41
| Facility | | $12.20 | $33.24 | $54.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.55 / $12.20 / $21.90
| Professional | | $11.55 | $12.20 | $21.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.67 / $26.11 / $100.00
| Facility | | $11.67 | $26.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.68 / $12.80 / $31.18
| Professional | | $7.68 | $12.80 | $31.18 |
- 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
- $12.03 / $12.03 / $16.38
| Professional | | $12.03 | $12.03 | $16.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.94 / $19.03 / $43.75
| Facility | | $8.94 | $19.03 | $43.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.70 / $14.15 / $21.69
| Professional | | $7.70 | $14.15 | $21.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.67 / $3,472.00 / $9,239.00
| Facility | | $52.67 | $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
- $12.80 / $17.73 / $47.64
| Professional | | $12.80 | $17.73 | $47.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.11 / $100.00 / $100.00
| Facility | | $26.11 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.14 / $8.59 / $27.03
| Professional | | $6.14 | $8.59 | $27.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.12 / $7.68 / $24.40
| Professional | | $5.12 | $7.68 | $24.40 |