- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.41 / $60.05 / $303.57
| Facility | | $20.41 | $60.05 | $303.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.13 / $13.55 / $30.10
| Professional | | $11.13 | $13.55 | $30.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.53 / $10.46 / $10.76
| Professional | | $7.53 | $10.46 | $10.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.42 / $27.25 / $52.44
| Facility | | $8.42 | $27.25 | $52.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.72 / $12.68 / $18.07
| Professional | | $8.72 | $12.68 | $18.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.53 / $24.45 / $44.01
| Facility | | $10.53 | $24.45 | $44.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.41 / $11.76 / $17.35
| Professional | | $9.41 | $11.76 | $17.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.04 / $13.65 / $100.00
| Facility | | $12.04 | $13.65 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $12.62 / $15.05
| Professional | | $9.02 | $12.62 | $15.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $12.39 / $15.05
| Professional | | $9.02 | $12.39 | $15.05 |