- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.20 / $45.78 / $128.93
| Facility | | $17.20 | $45.78 | $128.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.99 / $16.39 / $19.61
| Professional | | $14.99 | $16.39 | $19.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.69 / $35.85 / $100.00
| Facility | | $15.69 | $35.85 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.26 / $17.20 / $41.90
| Professional | | $8.26 | $17.20 | $41.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.35 / $48.33 / $84.50
| Facility | | $30.35 | $48.33 | $84.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.17 / $16.17 / $22.01
| Professional | | $16.17 | $16.17 | $22.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $25.56 / $58.77
| Facility | | $12.02 | $25.56 | $58.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.41 / $19.02 / $28.93
| Professional | | $10.41 | $19.02 | $28.93 |
- 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
- $24.74 / $24.74 / $29.10
| Professional | | $24.74 | $24.74 | $29.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.20 / $23.84 / $64.05
| Professional | | $17.20 | $23.84 | $64.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.87 / $21.05 / $135.38
| Facility | | $19.87 | $21.05 | $135.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.85 / $100.00 / $100.00
| Facility | | $35.85 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $10.32 / $36.32
| Professional | | $5.25 | $10.32 | $36.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $10.32 / $32.78
| Professional | | $5.25 | $10.32 | $32.78 |