- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $16.22 / $20.89
| Facility | | $12.59 | $16.22 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $13.49 / $51.29
| Professional | | $8.91 | $13.49 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Low / Median / High Price
- $7.41 / $25.70 / $25.70
| Professional | CQ | $7.41 | $25.70 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $27.54 / $44.67
| Facility | | $20.89 | $27.54 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.22 / $27.54 / $30.20
| Professional | | $16.22 | $27.54 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $75.86 / $100.00
| Facility | | $70.79 | $75.86 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.18 / $14.13 / $25.12
| Professional | | $13.18 | $14.13 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.48 / $16.22 / $30.90
| Facility | | $11.48 | $16.22 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $22.91 / $28.84
| Professional | | $11.75 | $22.91 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- CQ
- Low / Median / High Price
- $7.41 / $10.00 / $25.70
| Professional | CQ | $7.41 | $10.00 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $20.89 / $32.36
| Facility | | $20.89 | $20.89 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $15.14 / $21.38
| Professional | | $13.80 | $15.14 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $14.13 / $33.11
| Professional | | $13.80 | $14.13 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.18 / $15.49 / $16.60
| Professional | | $13.18 | $15.49 | $16.60 |