- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.96 / $19.42 / $35.11
| Facility | | $6.96 | $19.42 | $35.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.58 / $6.96 / $12.72
| Professional | | $6.58 | $6.96 | $12.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.66 / $15.93 / $100.00
| Facility | | $6.66 | $15.93 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.96 / $8.26 / $20.12
| Professional | | $4.96 | $8.26 | $20.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.86 / $20.48 / $35.79
| Facility | | $12.86 | $20.48 | $35.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $7.76 / $9.34
| Professional | | $7.76 | $7.76 | $9.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.77 / $11.02 / $24.93
| Facility | | $5.77 | $11.02 | $24.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $8.07 / $12.39
| Professional | | $5.00 | $8.07 | $12.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.96 / $3,472.00 / $9,239.00
| Facility | | $25.96 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.13 / $12.13 / $14.27
| Professional | | $12.13 | $12.13 | $14.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.26 / $11.45 / $27.67
| Professional | | $8.26 | $11.45 | $27.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.93 / $100.00 / $100.00
| Facility | | $15.93 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.62 / $4.96 / $15.41
| Professional | | $3.62 | $4.96 | $15.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.62 / $6.12 / $32.76
| Professional | | $3.62 | $6.12 | $32.76 |