- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $30.20 / $131.83
| Facility | | $5.89 | $30.20 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.98 / $19.05
| Professional | | $3.02 | $3.98 | $19.05 |
- 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
- $2.57 / $4.27 / $9.33
| Professional | | $2.57 | $4.27 | $9.33 |
- 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
- $3.98 / $3.98 / $5.50
| Professional | | $3.98 | $3.98 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $6.76 / $16.60
| Facility | | $3.31 | $6.76 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.09 / $5.37 / $7.24
| Professional | | $3.09 | $5.37 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.17 / $3,630.78 / $9,772.37
| Facility | | $4.17 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $6.03 / $7.08
| Professional | | $6.03 | $6.03 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.27 / $4.27 / $12.88
| Professional | | $4.27 | $4.27 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.90 / $22.39 / $30.90
| Facility | | $4.90 | $22.39 | $30.90 |
- 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
- $2.57 / $4.27 / $9.33
| Professional | | $2.57 | $4.27 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.45 / $4.27 / $7.08
| Facility | | $2.45 | $4.27 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $3.72 / $10.23
| Professional | | $2.09 | $3.72 | $10.23 |