- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.94 / $4.92 / $7.31
| Facility | | $3.94 | $4.92 | $7.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.69 / $3.12 / $9.86
| Professional | | $2.69 | $3.12 | $9.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.05 / $8.52 / $9.02
| Facility | | $7.05 | $8.52 | $9.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.31 / $1.31 / $13.39
| Professional | | $1.31 | $1.31 | $13.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.87 / $8.02 / $8.33
| Facility | | $1.87 | $8.02 | $8.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.01 / $10.53 / $16.14
| Facility | | $9.01 | $10.53 | $16.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $8.83 / $10.03
| Professional | | $3.72 | $8.83 | $10.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.23 / $2.41 / $3.94
| Facility | | $2.23 | $2.41 | $3.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.23 / $2.69 / $100.00
| Facility | | $2.23 | $2.69 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.90 / $2.75 / $7.35
| Professional | | $1.90 | $2.75 | $7.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.64 / $4.92 / $85.00
| Professional | | $1.64 | $4.92 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.23 / $2.41 / $3.94
| Facility | | $2.23 | $2.41 | $3.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $7.92 / $24.57
| Professional | | $3.80 | $7.92 | $24.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.56 / $6.56 / $100.00
| Facility | | $6.56 | $6.56 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.63 / $1.68 / $2.35
| Professional | | $1.63 | $1.68 | $2.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.98 / $6.98 / $7.21
| Professional | | $6.98 | $6.98 | $7.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.21 / $11.89 / $17.91
| Professional | | $7.21 | $11.89 | $17.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.28 / $3.28 / $3.28
| Facility | | $3.28 | $3.28 | $3.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.77 / $2.31 / $8.69
| Professional | | $1.77 | $2.31 | $8.69 |