- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.68 / $10.60 / $42.00
| Facility | | $3.68 | $10.60 | $42.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $3.53 / $8.07
| Professional | | $3.39 | $3.53 | $8.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $2.73 / $6.66
| Professional | | $2.35 | $2.73 | $6.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.12 / $10.78 / $100.00
| Facility | | $4.12 | $10.78 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $3.57 / $6.75
| Professional | | $1.94 | $3.57 | $6.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.71 / $8.02 / $15.79
| Facility | | $2.71 | $8.02 | $15.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $5.36 / $7.79
| Professional | | $2.75 | $5.36 | $7.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.79 / $3.78 / $4.15
| Professional | | $2.79 | $3.78 | $4.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.92 / $4.12 / $10.25
| Facility | | $3.92 | $4.12 | $10.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.53 / $3.92 / $3.92
| Facility | | $3.53 | $3.92 | $3.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.53 / $3.53 / $3.53
| Professional | | $3.53 | $3.53 | $3.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.51 / $6.47 / $10.78
| Facility | | $4.51 | $6.47 | $10.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.94 / $3.92 / $10.78
| Professional | | $2.94 | $3.92 | $10.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.96 / $2.96 / $2.96
| Facility | | $2.96 | $2.96 | $2.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $2.52 / $4.70
| Professional | | $2.35 | $2.52 | $4.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.02 / $2.02 / $2.02
| Professional | | $2.02 | $2.02 | $2.02 |