- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.01 / $19.50 / $33.11
| Facility | | $5.01 | $19.50 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $8.91 / $24.55
| Professional | | $5.01 | $8.91 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $12.88 / $100.00
| Facility | | $8.32 | $12.88 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $10.00 / $23.44
| Professional | | $3.72 | $10.00 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $22.39 / $31.62
| Facility | | $17.78 | $22.39 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $10.47 / $10.96
| Professional | | $7.08 | $10.47 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.03 / $10.96 / $21.38
| Facility | | $6.03 | $10.96 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.27 / $13.18 / $16.98
| Professional | | $4.27 | $13.18 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $3,630.78 / $9,772.37
| Facility | | $7.94 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.22 / $16.22 / $19.05
| Professional | | $16.22 | $16.22 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $11.22 / $23.99
| Professional | | $11.22 | $11.22 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $12.88 / $100.00
| Facility | | $8.32 | $12.88 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $10.00 / $23.44
| Professional | | $3.72 | $10.00 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.57 / $9.33 / $11.22
| Facility | | $4.57 | $9.33 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $6.76 / $21.38
| Professional | | $3.16 | $6.76 | $21.38 |