- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.70 / $7.13 / $10.59
| Facility | | $5.70 | $7.13 | $10.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.90 / $4.47 / $18.68
| Professional | | $3.90 | $4.47 | $18.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.21 / $12.35 / $13.06
| Facility | | $10.21 | $12.35 | $13.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $2.34 / $19.66
| Professional | | $2.34 | $2.34 | $19.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.17 / $12.88 / $13.39
| Facility | | $3.17 | $12.88 | $13.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.52 / $15.80 / $24.23
| Facility | | $13.52 | $15.80 | $24.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $12.79 / $14.54
| Professional | | $5.78 | $12.79 | $14.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.23 / $4.23 / $5.70
| Facility | | $4.23 | $4.23 | $5.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.90 / $4.28 / $100.00
| Facility | | $3.90 | $4.28 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.85 / $4.75 / $13.16
| Professional | | $2.85 | $4.75 | $13.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.38 / $9.31 / $85.00
| Professional | | $2.38 | $9.31 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.23 / $4.23 / $5.70
| Facility | | $4.23 | $4.23 | $5.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.80 / $11.88 / $74.67
| Professional | | $5.80 | $11.88 | $74.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.50 / $9.50 / $100.00
| Facility | | $9.50 | $9.50 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $3.10 / $4.70
| Professional | | $2.52 | $3.10 | $4.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.11 / $10.11 / $18.32
| Professional | | $10.11 | $10.11 | $18.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.32 / $18.32 / $25.94
| Professional | | $18.32 | $18.32 | $25.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.85 / $4.01 / $13.94
| Professional | | $2.85 | $4.01 | $13.94 |