- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.79 / $59.81 / $427.02
| Facility | | $15.79 | $59.81 | $427.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.56 / $13.35 / $307.05
| Professional | | $12.56 | $13.35 | $307.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.74 / $10.41 / $11.49
| Professional | | $9.74 | $10.41 | $11.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.38 / $32.92 / $54.85
| Facility | | $8.38 | $32.92 | $54.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.68 / $12.63 / $18.00
| Professional | | $8.68 | $12.63 | $18.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.49 / $24.35 / $43.83
| Facility | | $10.49 | $24.35 | $43.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.15 / $18.17 / $22.71
| Professional | | $10.15 | $18.17 | $22.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.24 / $13.07 / $100.00
| Facility | | $11.24 | $13.07 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.30 / $8.80 / $13.81
| Professional | | $6.30 | $8.80 | $13.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.30 / $8.80 / $12.24
| Professional | | $6.30 | $8.80 | $12.24 |