- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $7.41 / $40.60
| Facility | | $5.25 | $7.41 | $40.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $3.20 / $4.70
| Professional | | $2.62 | $3.20 | $4.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $11.05 / $100.00
| Facility | | $3.24 | $11.05 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $4.26 / $10.40
| Professional | | $2.25 | $4.26 | $10.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.17 / $9.82 / $17.18
| Facility | | $6.17 | $9.82 | $17.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.01 / $4.01 / $4.53
| Professional | | $4.01 | $4.01 | $4.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.98 / $5.53 / $12.12
| Facility | | $2.98 | $5.53 | $12.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.50 / $4.96 / $6.71
| Professional | | $2.50 | $4.96 | $6.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.11 / $3,472.00 / $9,239.00
| Facility | | $18.11 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.07 / $6.07 / $7.14
| Professional | | $6.07 | $6.07 | $7.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.26 / $5.92 / $13.88
| Professional | | $4.26 | $5.92 | $13.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.99 / $5.47 / $38.28
| Facility | | $4.99 | $5.47 | $38.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.82 / $100.00 / $100.00
| Facility | | $16.82 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $4.26 / $7.50
| Professional | | $2.10 | $4.26 | $7.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.65 / $4.50 / $9.49
| Facility | | $3.65 | $4.50 | $9.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $2.98 / $6.35
| Professional | | $2.10 | $2.98 | $6.35 |