- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.66 / $16.95 / $31.32
| Facility | | $6.66 | $16.95 | $31.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.65 / $6.66 / $12.61
| Professional | | $6.65 | $6.66 | $12.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.72 / $15.05 / $100.00
| Facility | | $6.72 | $15.05 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.54 / $7.37 / $17.95
| Professional | | $3.54 | $7.37 | $17.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.78 / $20.48 / $35.79
| Facility | | $12.78 | $20.48 | $35.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.93 / $6.93 / $8.94
| Professional | | $6.93 | $6.93 | $8.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.15 / $10.95 / $25.16
| Facility | | $5.15 | $10.95 | $25.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.37 / $7.71 / $12.66
| Professional | | $4.37 | $7.71 | $12.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.89 / $3,472.00 / $9,239.00
| Facility | | $36.89 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.73 / $10.73 / $12.62
| Professional | | $10.73 | $10.73 | $12.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.37 / $10.21 / $26.75
| Professional | | $7.37 | $10.21 | $26.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.05 / $100.00 / $100.00
| Facility | | $15.05 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $4.42 / $14.75
| Professional | | $3.15 | $4.42 | $14.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $4.42 / $14.05
| Professional | | $3.15 | $4.42 | $14.05 |