- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.80 / $30.91 / $57.12
| Facility | | $12.80 | $30.91 | $57.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.12 / $12.80 / $22.99
| Professional | | $12.12 | $12.80 | $22.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.26 / $23.39 / $100.00
| Facility | | $12.26 | $23.39 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.06 / $13.44 / $32.74
| Professional | | $8.06 | $13.44 | $32.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.66 / $37.68 / $65.88
| Facility | | $23.66 | $37.68 | $65.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.63 / $12.63 / $17.19
| Professional | | $12.63 | $12.63 | $17.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.40 / $19.96 / $45.93
| Facility | | $9.40 | $19.96 | $45.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.11 / $14.85 / $22.60
| Professional | | $8.11 | $14.85 | $22.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.64 / $3,472.00 / $9,239.00
| Facility | | $41.64 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.60 / $19.60 / $23.06
| Professional | | $19.60 | $19.60 | $23.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.44 / $18.63 / $50.02
| Professional | | $13.44 | $18.63 | $50.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.39 / $100.00 / $100.00
| Facility | | $23.39 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.45 / $9.01 / $28.37
| Professional | | $6.45 | $9.01 | $28.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.45 / $11.26 / $25.62
| Professional | | $6.45 | $11.26 | $25.62 |