- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.61 / $19.05 / $53.70
| Facility | | $6.61 | $19.05 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.89 / $15.85
| Professional | | $3.02 | $3.89 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.89 / $6.03 / $100.00
| Facility | | $3.89 | $6.03 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $4.68 / $9.77
| Professional | | $2.09 | $4.68 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.51 / $10.72 / $16.98
| Facility | | $8.51 | $10.72 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.47 / $4.47 / $5.50
| Professional | | $4.47 | $4.47 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.47 / $6.76 / $16.60
| Facility | | $3.47 | $6.76 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.09 / $5.75 / $7.24
| Professional | | $3.09 | $5.75 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.17 / $3,630.78 / $9,772.37
| Facility | | $6.17 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $7.08 / $8.32
| Professional | | $7.08 | $7.08 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.68 / $4.68 / $13.18
| Professional | | $4.68 | $4.68 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.89 / $5.75 / $45.71
| Facility | | $3.89 | $5.75 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.89 / $6.03 / $100.00
| Facility | | $3.89 | $6.03 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $4.68 / $9.77
| Professional | | $2.14 | $4.68 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.47 / $6.61 / $8.32
| Facility | | $4.47 | $6.61 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $4.57 / $7.08
| Professional | | $4.17 | $4.57 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.45 / $4.68 / $7.08
| Facility | | $2.45 | $4.68 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $3.63 / $10.23
| Professional | | $2.09 | $3.63 | $10.23 |