- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $12.30 / $40.74
| Facility | | $5.25 | $12.30 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.55 / $25.12
| Professional | | $2.00 | $3.55 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.55 / $5.50 / $100.00
| Facility | | $3.55 | $5.50 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $3.89 / $8.13
| Professional | | $2.14 | $3.89 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.41 / $9.33 / $13.49
| Facility | | $7.41 | $9.33 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $3.72 / $3.80
| Professional | | $3.72 | $3.72 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.09 / $6.17 / $15.14
| Facility | | $3.09 | $6.17 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.88 / $5.01 / $6.76
| Professional | | $2.88 | $5.01 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.17 / $17.78 / $7,079.46
| Facility | | $4.17 | $17.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.07 / $5.25 / $7.08
| Professional | | $4.07 | $5.25 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.89 / $3.89 / $9.12
| Professional | | $3.89 | $3.89 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.55 / $4.79 / $19.50
| Facility | | $3.55 | $4.79 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.55 / $5.50 / $100.00
| Facility | | $3.55 | $5.50 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $3.89 / $8.13
| Professional | | $2.34 | $3.89 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $3.47 / $5.89
| Professional | | $2.95 | $3.47 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.24 / $3.89 / $6.61
| Facility | | $2.24 | $3.89 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $3.89 / $7.76
| Professional | | $2.09 | $3.89 | $7.76 |