- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.57 / $6.96 / $10.35
| Facility | | $5.57 | $6.96 | $10.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $4.05 / $5.57
| Professional | | $3.80 | $4.05 | $5.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.98 / $12.06 / $12.76
| Facility | | $9.98 | $12.06 | $12.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.29 / $2.29 / $19.20
| Professional | | $2.29 | $2.29 | $19.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.10 / $12.59 / $13.08
| Facility | | $3.10 | $12.59 | $13.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.62 / $14.74 / $22.62
| Facility | | $12.62 | $14.74 | $22.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.37 / $12.50 / $14.20
| Professional | | $5.37 | $12.50 | $14.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.13 / $4.13 / $5.57
| Facility | | $4.13 | $4.13 | $5.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.80 / $4.18 / $100.00
| Facility | | $3.80 | $4.18 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.78 / $4.63 / $12.85
| Professional | | $2.78 | $4.63 | $12.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.31 / $12.81 / $85.00
| Professional | | $2.31 | $12.81 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.13 / $4.13 / $5.57
| Facility | | $4.13 | $4.13 | $5.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.67 / $11.09 / $54.90
| Professional | | $5.67 | $11.09 | $54.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.27 / $9.27 / $100.00
| Facility | | $9.27 | $9.27 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.46 / $3.10 / $4.44
| Professional | | $2.46 | $3.10 | $4.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.76 / $4.76 / $9.88
| Professional | | $4.76 | $4.76 | $9.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.76 / $21.78 / $25.33
| Professional | | $4.76 | $21.78 | $25.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.69 / $3.91 / $12.72
| Professional | | $2.69 | $3.91 | $12.72 |