- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.09 / $30.96 / $49.46
| Facility | | $11.09 | $30.96 | $49.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.16 / $11.09 / $13.27
| Professional | | $6.16 | $11.09 | $13.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.61 / $20.23 / $100.00
| Facility | | $10.61 | $20.23 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.98 / $11.63 / $28.33
| Professional | | $6.98 | $11.63 | $28.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.57 / $32.76 / $57.28
| Facility | | $20.57 | $32.76 | $57.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.93 / $10.93 / $14.89
| Professional | | $10.93 | $10.93 | $14.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $17.27 / $39.72
| Facility | | $8.13 | $17.27 | $39.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $12.86 / $19.89
| Professional | | $7.08 | $12.86 | $19.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.15 / $3,472.00 / $9,239.00
| Facility | | $32.15 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.80 / $16.80 / $19.78
| Professional | | $16.80 | $16.80 | $19.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.63 / $16.12 / $43.32
| Professional | | $11.63 | $16.12 | $43.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.16 / $15.16 / $15.16
| Facility | | $15.16 | $15.16 | $15.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.23 / $100.00 / $100.00
| Facility | | $20.23 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.58 / $7.80 / $24.57
| Professional | | $5.58 | $7.80 | $24.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.58 / $7.80 / $24.57
| Professional | | $5.58 | $7.80 | $24.57 |