- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.54 / $32.57 / $109.82
| Facility | | $11.54 | $32.57 | $109.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.17 / $9.71 / $15.84
| Professional | | $9.17 | $9.71 | $15.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.28 / $20.07 / $100.00
| Facility | | $9.28 | $20.07 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $11.54 / $28.11
| Professional | | $6.50 | $11.54 | $28.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.00 / $28.67 / $50.13
| Facility | | $18.00 | $28.67 | $50.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.85 / $10.85 / $13.04
| Professional | | $10.85 | $10.85 | $13.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.06 / $15.38 / $34.84
| Facility | | $8.06 | $15.38 | $34.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.87 / $11.26 / $17.57
| Professional | | $6.87 | $11.26 | $17.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.12 / $3,472.00 / $9,239.00
| Facility | | $46.12 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.80 / $16.80 / $19.78
| Professional | | $16.80 | $16.80 | $19.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.54 / $15.99 / $38.65
| Professional | | $11.54 | $15.99 | $38.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.28 / $13.28 / $39.78
| Facility | | $13.28 | $13.28 | $39.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.07 / $100.00 / $100.00
| Facility | | $20.07 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $11.54 / $21.51
| Professional | | $3.15 | $11.54 | $21.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.27 / $11.54 / $25.85
| Professional | | $6.27 | $11.54 | $25.85 |