- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.54 / $7.74 / $21.70
| Facility | | $2.54 | $7.74 | $21.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.21 / $2.29 / $5.08
| Professional | | $2.21 | $2.29 | $5.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.31 / $4.42 / $100.00
| Facility | | $2.31 | $4.42 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.52 / $2.54 / $6.19
| Professional | | $1.52 | $2.54 | $6.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.63 / $7.38 / $12.90
| Facility | | $4.63 | $7.38 | $12.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $2.39 / $3.25
| Professional | | $2.39 | $2.39 | $3.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.77 / $3.78 / $8.68
| Facility | | $1.77 | $3.78 | $8.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.49 / $2.82 / $4.63
| Professional | | $1.49 | $2.82 | $4.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.01 / $3,472.00 / $9,239.00
| Facility | | $9.01 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.74 / $3.74 / $4.40
| Professional | | $3.74 | $3.74 | $4.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $3.52 / $9.44
| Professional | | $2.54 | $3.52 | $9.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.78 / $3.09 / $3.31
| Facility | | $2.78 | $3.09 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.42 / $100.00 / $100.00
| Facility | | $4.42 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.22 / $1.70 / $5.36
| Professional | | $1.22 | $1.70 | $5.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $2.61 / $3.20
| Professional | | $2.24 | $2.61 | $3.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.52 / $4.84
| Professional | | $1.07 | $1.52 | $4.84 |