- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.57 / $18.32 / $33.43
| Facility | | $6.57 | $18.32 | $33.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.21 / $6.57 / $13.76
| Professional | | $6.21 | $6.57 | $13.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.61 / $16.43 / $100.00
| Facility | | $8.61 | $16.43 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.66 / $9.44 / $21.37
| Professional | | $5.66 | $9.44 | $21.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.64 / $26.21 / $45.83
| Facility | | $13.64 | $26.21 | $45.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.82 / $8.86 / $9.35
| Professional | | $8.82 | $8.86 | $9.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.60 / $12.22 / $23.56
| Facility | | $6.60 | $12.22 | $23.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $7.62 / $14.45
| Professional | | $5.05 | $7.62 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.26 / $3,472.00 / $9,239.00
| Facility | | $32.26 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.53 / $13.53 / $15.92
| Professional | | $13.53 | $13.53 | $15.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $13.08 / $33.67
| Professional | | $9.44 | $13.08 | $33.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.43 / $100.00 / $100.00
| Facility | | $16.43 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.78 / $5.66 / $14.54
| Professional | | $3.78 | $5.66 | $14.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.96 / $5.77 / $14.54
| Professional | | $3.96 | $5.77 | $14.54 |