- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.25 / $9.38 / $40.29
| Facility | | $3.25 | $9.38 | $40.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.13 / $3.25
| Professional | | $2.06 | $2.13 | $3.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.16 / $6.59 / $100.00
| Facility | | $2.16 | $6.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.59 / $2.37 / $5.77
| Professional | | $1.59 | $2.37 | $5.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.11 / $6.55 / $11.45
| Facility | | $4.11 | $6.55 | $11.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.23 / $2.23 / $3.04
| Professional | | $2.23 | $2.23 | $3.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.65 / $3.52 / $8.11
| Facility | | $1.65 | $3.52 | $8.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.46 / $2.62 / $4.16
| Professional | | $1.46 | $2.62 | $4.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.82 / $17.97 / $8,090.00
| Facility | | $2.82 | $17.97 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.42 / $3.12 / $3.84
| Professional | | $2.42 | $3.12 | $3.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $3.28 / $9.43
| Professional | | $2.37 | $3.28 | $9.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.79 / $3.30 / $21.79
| Facility | | $2.79 | $3.30 | $21.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.95 / $100.00 / $100.00
| Facility | | $11.95 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $2.37 / $5.00
| Professional | | $1.42 | $2.37 | $5.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.19 / $2.85 / $5.41
| Facility | | $2.19 | $2.85 | $5.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.29 / $2.44 / $2.99
| Professional | | $2.29 | $2.44 | $2.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $2.10 / $4.24
| Professional | | $1.42 | $2.10 | $4.24 |