- 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
- $7.85 / $20.32 / $100.00
| Facility | | $7.85 | $20.32 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.13 / $8.60 / $20.51
| Professional | | $4.13 | $8.60 | $20.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.70 / $23.75 / $41.53
| Facility | | $11.70 | $23.75 | $41.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.08 / $8.08 / $8.51
| Professional | | $8.08 | $8.08 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.01 / $12.79 / $29.41
| Facility | | $6.01 | $12.79 | $29.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.20 / $8.07 / $14.46
| Professional | | $5.20 | $8.07 | $14.46 |
- 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
- $12.61 / $12.61 / $14.83
| Professional | | $12.61 | $12.61 | $14.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.60 / $11.92 / $30.69
| Professional | | $8.60 | $11.92 | $30.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.98 / $100.00 / $100.00
| Facility | | $30.98 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $5.16 / $14.42
| Professional | | $3.15 | $5.16 | $14.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $5.16 / $14.42
| Professional | | $3.15 | $5.16 | $14.42 |