- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $13.49 / $16.60
| Facility | | $7.08 | $13.49 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $3.98 / $7.08
| Professional | | $3.98 | $3.98 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $16.22 / $16.60
| Facility | | $12.88 | $16.22 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.45 / $22.91
| Professional | | $2.45 | $2.45 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.07 / $4.07 / $4.07
| Facility | | $4.07 | $4.07 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.22 / $19.05 / $30.20
| Facility | | $16.22 | $19.05 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $8.71 / $19.05
| Professional | | $7.08 | $8.71 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.47 / $12.02 / $39.81
| Facility | | $4.47 | $12.02 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.47 / $5.50 / $100.00
| Facility | | $4.47 | $5.50 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.09 / $4.17 / $11.48
| Professional | | $3.09 | $4.17 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.13 / $17.78 / $64.57
| Professional | | $5.13 | $17.78 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $15.49 / $44.67
| Professional | | $7.76 | $15.49 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $100.00
| Facility | | $12.02 | $12.02 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.24 / $3.24 / $5.01
| Professional | | $3.24 | $3.24 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.13 / $5.13 / $12.88
| Professional | | $5.13 | $5.13 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.13 / $5.13 / $33.11
| Professional | | $5.13 | $5.13 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.80 / $4.79 / $7.24
| Facility | | $3.80 | $4.79 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.51 / $4.17 / $12.30
| Professional | | $2.51 | $4.17 | $12.30 |