- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.92 / $39.38 / $132.06
| Facility | | $12.92 | $39.38 | $132.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.53 / $11.70 / $12.92
| Professional | | $11.53 | $11.70 | $12.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.78 / $29.21 / $100.00
| Facility | | $11.78 | $29.21 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.75 / $12.92 / $31.47
| Professional | | $7.75 | $12.92 | $31.47 |
- 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
- $12.14 / $12.14 / $16.53
| Professional | | $12.14 | $12.14 | $16.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.02 / $19.19 / $44.13
| Facility | | $9.02 | $19.19 | $44.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.70 / $14.27 / $21.69
| Professional | | $7.70 | $14.27 | $21.69 |
- 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
- $18.67 / $18.67 / $21.97
| Professional | | $18.67 | $18.67 | $21.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.92 / $17.91 / $48.07
| Professional | | $12.92 | $17.91 | $48.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.61 / $14.85 / $58.62
| Facility | | $11.61 | $14.85 | $58.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.21 / $100.00 / $100.00
| Facility | | $29.21 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.20 / $8.66 / $27.26
| Professional | | $6.20 | $8.66 | $27.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.20 / $8.66 / $27.26
| Professional | | $6.20 | $8.66 | $27.26 |