- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.51 / $22.39 / $87.10
| Facility | | $8.51 | $22.39 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $7.59 / $38.02
| Professional | | $6.03 | $7.59 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.76 / $12.02 / $100.00
| Facility | | $7.76 | $12.02 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $8.51 / $17.78
| Professional | | $5.01 | $8.51 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $20.89 / $33.11
| Facility | | $16.60 | $20.89 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $7.94 / $10.72
| Professional | | $7.94 | $7.94 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.61 / $13.49 / $32.36
| Facility | | $6.61 | $13.49 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.17 / $10.23 / $14.45
| Professional | | $6.17 | $10.23 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $3,630.78 / $9,772.37
| Facility | | $12.02 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $14.13
| Professional | | $12.02 | $12.02 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.51 / $8.51 / $25.70
| Professional | | $8.51 | $8.51 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.59 / $10.23 / $83.18
| Facility | | $7.59 | $10.23 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.76 / $12.02 / $100.00
| Facility | | $7.76 | $12.02 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $8.51 / $17.78
| Professional | | $5.01 | $8.51 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.79 / $8.51 / $14.13
| Facility | | $4.79 | $8.51 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $7.59 / $17.78
| Professional | | $4.17 | $7.59 | $17.78 |