- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.31 / $3,133.00 / $10,651.00
| Facility | | $30.31 | $3,133.00 | $10,651.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.97 / $15.30 / $17.10
| Professional | | $11.97 | $15.30 | $17.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.03 / $51.84 / $82.44
| Facility | | $19.03 | $51.84 | $82.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.56 / $7.56 / $13.82
| Professional | | $7.56 | $7.56 | $13.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.53 / $17.20 / $46.33
| Facility | | $10.53 | $17.20 | $46.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.00 / $13.64 / $25.81
| Professional | | $11.00 | $13.64 | $25.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.68 / $19.55 / $31.73
| Facility | | $13.68 | $19.55 | $31.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.06 / $23.40 / $66.42
| Professional | | $12.06 | $23.40 | $66.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.30 / $13.58 / $22.64
| Facility | | $13.30 | $13.58 | $22.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.56 / $10.56 / $13.32
| Professional | | $7.56 | $10.56 | $13.32 |