- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.05 / $18.44 / $81.31
| Facility | | $6.05 | $18.44 | $81.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.46 / $5.52 / $10.35
| Professional | | $5.46 | $5.52 | $10.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.52 / $12.83 / $100.00
| Facility | | $5.52 | $12.83 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.63 / $6.05 / $14.74
| Professional | | $3.63 | $6.05 | $14.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.64 / $17.20 / $30.08
| Facility | | $10.64 | $17.20 | $30.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.69 / $5.69 / $7.42
| Professional | | $5.69 | $5.69 | $7.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.22 / $8.97 / $20.69
| Facility | | $4.22 | $8.97 | $20.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.56 / $6.42 / $10.40
| Professional | | $3.56 | $6.42 | $10.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.33 / $3,472.00 / $9,239.00
| Facility | | $26.33 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.86 / $8.86 / $10.43
| Professional | | $8.86 | $8.86 | $10.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.05 / $8.39 / $22.20
| Professional | | $6.05 | $8.39 | $22.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.12 / $7.12 / $31.23
| Facility | | $7.12 | $7.12 | $31.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.83 / $100.00 / $100.00
| Facility | | $12.83 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.90 / $4.07 / $12.24
| Professional | | $2.90 | $4.07 | $12.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.45 / $6.05 / $7.26
| Facility | | $5.45 | $6.05 | $7.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.72 / $4.87 / $12.24
| Professional | | $2.72 | $4.87 | $12.24 |