- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.01 / $35.96 / $72.95
| Facility | | $14.01 | $35.96 | $72.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.56 / $14.01 / $16.77
| Professional | | $9.56 | $14.01 | $16.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.42 / $30.53 / $100.00
| Facility | | $13.42 | $30.53 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.83 / $14.71 / $35.83
| Professional | | $8.83 | $14.71 | $35.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.72 / $40.96 / $71.59
| Facility | | $25.72 | $40.96 | $71.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.83 / $13.83 / $18.82
| Professional | | $13.83 | $13.83 | $18.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.28 / $21.87 / $50.25
| Facility | | $10.28 | $21.87 | $50.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $16.26 / $24.86
| Professional | | $8.94 | $16.26 | $24.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.13 / $3,472.00 / $9,239.00
| Facility | | $52.13 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.00 / $21.00 / $24.70
| Professional | | $21.00 | $21.00 | $24.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.71 / $20.39 / $54.77
| Professional | | $14.71 | $20.39 | $54.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.23 / $17.32 / $19.17
| Facility | | $13.23 | $17.32 | $19.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.53 / $100.00 / $100.00
| Facility | | $30.53 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.06 / $9.86 / $31.05
| Professional | | $7.06 | $9.86 | $31.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.06 / $11.36 / $28.04
| Professional | | $7.06 | $11.36 | $28.04 |