- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.85 / $50.45 / $119.65
| Facility | | $11.85 | $50.45 | $119.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.06 / $7.54 / $9.52
| Professional | | $6.06 | $7.54 | $9.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.88 / $21.24 / $100.00
| Facility | | $7.88 | $21.24 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.19 / $8.65 / $21.07
| Professional | | $5.19 | $8.65 | $21.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.43 / $24.57 / $42.95
| Facility | | $15.43 | $24.57 | $42.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $8.13 / $11.06
| Professional | | $8.13 | $8.13 | $11.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.05 / $12.83 / $29.52
| Facility | | $6.05 | $12.83 | $29.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.20 / $9.55 / $14.46
| Professional | | $5.20 | $9.55 | $14.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.63 / $3,472.00 / $9,239.00
| Facility | | $32.63 | $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
- $8.65 / $11.99 / $32.19
| Professional | | $8.65 | $11.99 | $32.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.99 / $12.05 / $112.34
| Facility | | $9.99 | $12.05 | $112.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.24 / $100.00 / $100.00
| Facility | | $21.24 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.15 / $5.25 / $18.26
| Professional | | $4.15 | $5.25 | $18.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.39 / $9.86 / $19.25
| Facility | | $8.39 | $9.86 | $19.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.63 / $8.92 / $10.94
| Professional | | $7.63 | $8.92 | $10.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.46 / $5.19 / $15.48
| Professional | | $3.46 | $5.19 | $15.48 |