- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.44 / $22.31 / $139.85
| Facility | | $11.44 | $22.31 | $139.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.98 / $12.90 / $15.62
| Professional | | $10.98 | $12.90 | $15.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.27 / $10.27 / $10.27
| Professional | | $10.27 | $10.27 | $10.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.09 / $23.88 / $26.83
| Professional | | $11.09 | $23.88 | $26.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.32 / $32.47 / $67.73
| Facility | | $10.32 | $32.47 | $67.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.52 / $12.09 / $21.17
| Professional | | $9.52 | $12.09 | $21.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.80 / $8.72 / $11.82
| Professional | | $6.80 | $8.72 | $11.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.35 / $14.78 / $13,785.00
| Facility | | $10.35 | $14.78 | $13,785.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.35 / $10.35 / $13.59
| Professional | | $10.35 | $10.35 | $13.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.21 / $8.86 / $20.66
| Professional | | $6.21 | $8.86 | $20.66 |