- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $13.18 / $100.00
| Facility | | $5.89 | $13.18 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $7.94 / $12.88
| Professional | | $5.01 | $7.94 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $6.03 / $19.50
| Professional | | $6.03 | $6.03 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $11.22 / $11.22
| Facility | | $10.47 | $11.22 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $11.22 / $11.22
| Professional | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $21.88 / $50,118.72
| Facility | | $21.88 | $21.88 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.92 / $6.92 / $13.49
| Professional | | $6.92 | $6.92 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $22.91 / $53.70
| Facility | | $13.80 | $22.91 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $19.95 / $27.54
| Professional | | $12.59 | $19.95 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.07 / $4.07 / $4.27
| Facility | | $4.07 | $4.07 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.07 / $7.76 / $8.32
| Professional | | $4.07 | $7.76 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.71 / $50,118.72 / $75,857.76
| Facility | | $8.71 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $13.18 / $13.18
| Professional | | $9.12 | $13.18 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.47 / $6.76 / $12.30
| Professional | | $4.47 | $6.76 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.07 / $7.76 / $7.76
| Facility | | $4.07 | $7.76 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.07 / $7.76 / $8.32
| Professional | | $4.07 | $7.76 | $8.32 |