- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.26 / $62.00 / $144.28
| Facility | | $27.26 | $62.00 | $144.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.57 / $14.17 / $18.80
| Professional | | $10.57 | $14.17 | $18.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.83 / $33.63 / $100.00
| Facility | | $14.83 | $33.63 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.76 / $16.26 / $39.61
| Professional | | $9.76 | $16.26 | $39.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.81 / $45.87 / $80.20
| Facility | | $28.81 | $45.87 | $80.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.28 / $15.28 / $20.79
| Professional | | $15.28 | $15.28 | $20.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.36 / $24.12 / $55.56
| Facility | | $11.36 | $24.12 | $55.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $17.98 / $27.57
| Professional | | $9.77 | $17.98 | $27.57 |
- 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
- $23.34 / $23.34 / $27.46
| Professional | | $23.34 | $23.34 | $27.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.26 / $22.54 / $60.50
| Professional | | $16.26 | $22.54 | $60.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.86 / $21.19 / $154.66
| Facility | | $18.86 | $21.19 | $154.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.63 / $100.00 / $100.00
| Facility | | $33.63 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.80 / $10.91 / $34.32
| Professional | | $7.80 | $10.91 | $34.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.80 / $12.56 / $34.32
| Professional | | $7.80 | $12.56 | $34.32 |