- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.08 / $16.98 / $30.94
| Facility | | $6.08 | $16.98 | $30.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.08 / $6.08 / $12.76
| Professional | | $6.08 | $6.08 | $12.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.45 / $16.62 / $100.00
| Facility | | $7.45 | $16.62 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.82 / $9.55 / $19.94
| Professional | | $3.82 | $9.55 | $19.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.70 / $22.94 / $40.10
| Facility | | $11.70 | $22.94 | $40.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.16 / $8.98 / $9.44
| Professional | | $8.16 | $8.98 | $9.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.67 / $12.31 / $24.24
| Facility | | $6.67 | $12.31 | $24.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.24 / $7.06 / $14.45
| Professional | | $5.24 | $7.06 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.92 / $3,472.00 / $9,239.00
| Facility | | $28.92 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.01 / $14.01 / $16.48
| Professional | | $14.01 | $14.01 | $16.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $13.24 / $30.75
| Professional | | $9.55 | $13.24 | $30.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.62 / $100.00 / $100.00
| Facility | | $16.62 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $5.73 / $13.47
| Professional | | $3.15 | $5.73 | $13.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $5.73 / $13.47
| Professional | | $3.15 | $5.73 | $13.47 |