- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.11 / $36.50 / $147.97
| Facility | | $13.11 | $36.50 | $147.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.40 / $9.31 / $11.94
| Professional | | $7.40 | $9.31 | $11.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.41 / $24.78 / $100.00
| Facility | | $9.41 | $24.78 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.19 / $10.32 / $25.14
| Professional | | $6.19 | $10.32 | $25.14 |
- 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
- $9.69 / $9.69 / $13.21
| Professional | | $9.69 | $9.69 | $13.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.21 / $15.34 / $35.26
| Facility | | $7.21 | $15.34 | $35.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.24 / $11.42 / $17.63
| Professional | | $6.24 | $11.42 | $17.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.78 / $3,472.00 / $9,239.00
| Facility | | $46.78 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.93 / $14.93 / $17.57
| Professional | | $14.93 | $14.93 | $17.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.32 / $14.30 / $38.42
| Professional | | $10.32 | $14.30 | $38.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.15 / $13.31 / $40.72
| Facility | | $12.15 | $13.31 | $40.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.78 / $100.00 / $100.00
| Facility | | $24.78 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.95 / $6.92 / $21.80
| Professional | | $4.95 | $6.92 | $21.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.95 / $8.40 / $19.67
| Professional | | $4.95 | $8.40 | $19.67 |