- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $23.99 / $67.61
| Facility | | $8.91 | $23.99 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $5.89 / $42.66
| Professional | | $3.98 | $5.89 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $9.12 / $100.00
| Facility | | $5.89 | $9.12 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $6.46 / $13.80
| Professional | | $3.16 | $6.46 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $15.85 / $25.12
| Facility | | $12.59 | $15.85 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $6.03 / $8.32
| Professional | | $6.03 | $6.03 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.01 / $10.23 / $25.12
| Facility | | $5.01 | $10.23 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.68 / $7.76 / $10.96
| Professional | | $4.68 | $7.76 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $3,630.78 / $9,772.37
| Facility | | $9.33 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $9.33 / $10.96
| Professional | | $9.33 | $9.33 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $6.46 / $19.50
| Professional | | $6.46 | $6.46 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.75 / $9.33 / $41.69
| Facility | | $5.75 | $9.33 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $9.12 / $100.00
| Facility | | $5.89 | $9.12 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $6.46 / $13.80
| Professional | | $3.16 | $6.46 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.72 / $6.46 / $10.47
| Facility | | $3.72 | $6.46 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $5.37 / $15.49
| Professional | | $3.16 | $5.37 | $15.49 |