- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.02 / $22.14 / $40.90
| Facility | | $8.02 | $22.14 | $40.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.02 / $8.02 / $15.68
| Professional | | $8.02 | $8.02 | $15.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.36 / $23.45 / $100.00
| Facility | | $8.36 | $23.45 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.89 / $9.81 / $23.90
| Professional | | $5.89 | $9.81 | $23.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.43 / $25.40 / $44.40
| Facility | | $15.43 | $25.40 | $44.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.22 / $9.22 / $10.78
| Professional | | $9.22 | $9.22 | $10.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.86 / $13.58 / $31.28
| Facility | | $6.86 | $13.58 | $31.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.83 / $9.31 / $15.37
| Professional | | $5.83 | $9.31 | $15.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.37 / $3,472.00 / $9,239.00
| Facility | | $23.37 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.01 / $14.01 / $16.48
| Professional | | $14.01 | $14.01 | $16.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.81 / $13.60 / $32.78
| Professional | | $9.81 | $13.60 | $32.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.45 / $100.00 / $100.00
| Facility | | $23.45 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.54 / $6.14 / $17.79
| Professional | | $4.54 | $6.14 | $17.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.54 / $7.06 / $17.79
| Professional | | $4.54 | $7.06 | $17.79 |