- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.27 / $12.02 / $30.90
| Facility | | $4.27 | $12.02 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.98 / $20.42
| Professional | | $3.02 | $3.98 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.07 / $6.31 / $100.00
| Facility | | $4.07 | $6.31 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $4.47 / $9.55
| Professional | | $2.09 | $4.47 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.51 / $10.72 / $16.98
| Facility | | $8.51 | $10.72 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.27 / $4.27 / $5.75
| Professional | | $4.27 | $4.27 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.55 / $7.24 / $17.38
| Facility | | $3.55 | $7.24 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.24 / $5.37 / $7.76
| Professional | | $3.24 | $5.37 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $3,630.78 / $9,772.37
| Facility | | $5.25 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $6.46 / $7.76
| Professional | | $6.46 | $6.46 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.47 / $4.47 / $13.80
| Professional | | $4.47 | $4.47 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $26.92 / $28.18
| Facility | | $26.92 | $26.92 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.07 / $6.31 / $100.00
| Facility | | $4.07 | $6.31 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $4.47 / $9.55
| Professional | | $2.19 | $4.47 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $4.47 / $7.59
| Facility | | $2.57 | $4.47 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $3.80 / $10.72
| Professional | | $2.09 | $3.80 | $10.72 |