- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.59 / $44.73 / $165.78
| Facility | | $8.59 | $44.73 | $165.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $8.59 / $28.09
| Professional | | $8.13 | $8.59 | $28.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.12 / $28.72 / $100.00
| Facility | | $15.12 | $28.72 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.30 / $18.04 / $42.72
| Professional | | $6.30 | $18.04 | $42.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.86 / $45.06 / $81.63
| Facility | | $17.86 | $45.06 | $81.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.53 / $19.23 / $20.26
| Professional | | $11.53 | $19.23 | $20.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.97 / $17.96 / $34.83
| Facility | | $9.97 | $17.96 | $34.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $12.28 / $30.98
| Professional | | $6.03 | $12.28 | $30.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.54 / $3,472.00 / $9,239.00
| Facility | | $33.54 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.40 / $29.40 / $34.59
| Professional | | $29.40 | $29.40 | $34.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.46 / $27.01 / $65.88
| Professional | | $20.46 | $27.01 | $65.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.60 / $100.00 / $100.00
| Facility | | $35.60 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.30 / $12.28 / $19.04
| Professional | | $6.30 | $12.28 | $19.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.30 / $12.28 / $20.46
| Professional | | $6.30 | $12.28 | $20.46 |