- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.37 / $12.02 / $28.84
| Facility | | $4.37 | $12.02 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.98 / $16.98
| Professional | | $3.02 | $3.98 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.27 / $6.46 / $100.00
| Facility | | $4.27 | $6.46 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $4.68 / $9.77
| Professional | | $2.75 | $4.68 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.12 / $11.48 / $18.20
| Facility | | $9.12 | $11.48 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.37 / $4.37 / $5.89
| Professional | | $4.37 | $4.37 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.63 / $7.41 / $17.78
| Facility | | $3.63 | $7.41 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $5.75 / $7.76
| Professional | | $3.47 | $5.75 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $3,630.78 / $9,772.37
| Facility | | $8.13 | $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
- $4.68 / $4.68 / $14.13
| Professional | | $4.68 | $4.68 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.17 / $5.50 / $169.82
| Facility | | $4.17 | $5.50 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.27 / $6.46 / $100.00
| Facility | | $4.27 | $6.46 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $4.68 / $9.77
| Professional | | $2.75 | $4.68 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.63 / $4.68 / $7.76
| Facility | | $2.63 | $4.68 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.29 / $4.07 / $10.96
| Professional | | $2.29 | $4.07 | $10.96 |