- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.92 / $10.02 / $40.33
| Facility | | $7.92 | $10.02 | $40.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.51 / $4.68 / $5.78
| Professional | | $4.51 | $4.68 | $5.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.72 / $10.06 / $100.00
| Facility | | $4.72 | $10.06 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $5.78 / $14.08
| Professional | | $3.15 | $5.78 | $14.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.26 / $14.74 / $25.78
| Facility | | $9.26 | $14.74 | $25.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.43 / $5.43 / $6.62
| Professional | | $5.43 | $5.43 | $6.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.04 / $7.80 / $17.67
| Facility | | $4.04 | $7.80 | $17.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.54 / $5.72 / $8.77
| Professional | | $3.54 | $5.72 | $8.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.78 / $3,472.00 / $9,239.00
| Facility | | $19.78 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.40 / $8.40 / $9.89
| Professional | | $8.40 | $8.40 | $9.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $8.01 / $19.36
| Professional | | $5.78 | $8.01 | $19.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.65 / $6.75 / $12.54
| Facility | | $4.65 | $6.75 | $12.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.06 / $100.00 / $100.00
| Facility | | $10.06 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $3.47 / $10.92
| Professional | | $2.57 | $3.47 | $10.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.09 / $5.61 / $6.55
| Professional | | $5.09 | $5.61 | $6.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.43 / $3.47 / $10.92
| Professional | | $2.43 | $3.47 | $10.92 |