- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.50 / $42.32 / $93.89
| Facility | | $10.50 | $42.32 | $93.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.31 / $5.66 / $6.48
| Professional | | $5.31 | $5.66 | $6.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.91 / $11.28 / $100.00
| Facility | | $5.91 | $11.28 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.89 / $6.48 / $15.78
| Professional | | $3.89 | $6.48 | $15.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.31 / $18.02 / $31.50
| Facility | | $11.31 | $18.02 | $31.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.09 / $6.09 / $8.28
| Professional | | $6.09 | $6.09 | $8.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.53 / $9.63 / $22.14
| Facility | | $4.53 | $9.63 | $22.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.95 / $7.17 / $10.85
| Professional | | $3.95 | $7.17 | $10.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.71 / $40.85 / $6,679.00
| Facility | | $7.71 | $40.85 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $8.53 / $10.98
| Professional | | $6.61 | $8.53 | $10.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.48 / $8.98 / $25.76
| Professional | | $6.48 | $8.98 | $25.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.57 / $8.44 / $56.03
| Facility | | $7.57 | $8.44 | $56.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.28 / $100.00 / $100.00
| Facility | | $11.28 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.11 / $4.20 / $13.68
| Professional | | $3.11 | $4.20 | $13.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.28 / $7.39 / $14.40
| Facility | | $6.28 | $7.39 | $14.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.71 / $6.68 / $8.19
| Professional | | $5.71 | $6.68 | $8.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.17 / $2.17 / $2.17
| Facility | | $2.17 | $2.17 | $2.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.21 / $4.20 / $25.70
| Professional | | $3.21 | $4.20 | $25.70 |