- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.66 / $13.00 / $26.88
| Facility | | $4.66 | $13.00 | $26.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.28 / $4.66 / $8.36
| Professional | | $4.28 | $4.66 | $8.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.46 / $9.28 / $100.00
| Facility | | $4.46 | $9.28 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $5.00 / $12.18
| Professional | | $2.40 | $5.00 | $12.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.75 / $13.93 / $24.35
| Facility | | $8.75 | $13.93 | $24.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.70 / $4.70 / $6.25
| Professional | | $4.70 | $4.70 | $6.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.50 / $7.29 / $16.71
| Facility | | $3.50 | $7.29 | $16.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.91 / $5.41 / $8.14
| Professional | | $2.91 | $5.41 | $8.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.95 / $3,472.00 / $9,239.00
| Facility | | $12.95 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $7.00 / $8.24
| Professional | | $7.00 | $7.00 | $8.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $6.93 / $18.19
| Professional | | $5.00 | $6.93 | $18.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.75 / $6.07 / $6.31
| Facility | | $5.75 | $6.07 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.28 / $100.00 / $100.00
| Facility | | $9.28 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $3.00 / $10.32
| Professional | | $2.10 | $3.00 | $10.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.25 / $3.00 / $3.44
| Facility | | $2.25 | $3.00 | $3.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $3.00 / $9.52
| Professional | | $2.10 | $3.00 | $9.52 |