- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.70 / $17.48 / $48.00
| Facility | | $3.70 | $17.48 | $48.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.37 / $2.70
| Professional | | $2.11 | $2.37 | $2.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.46 / $6.67 / $60.00
| Facility | | $2.46 | $6.67 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.62 / $2.70 / $6.58
| Professional | | $1.62 | $2.70 | $6.58 |
- 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
- $2.54 / $2.54 / $3.39
| Professional | | $2.54 | $2.54 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.89 / $4.03 / $9.22
| Facility | | $1.89 | $4.03 | $9.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.67 / $2.98 / $4.51
| Professional | | $1.67 | $2.98 | $4.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.55 / $3,472.00 / $9,239.00
| Facility | | $10.55 | $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
- $2.70 / $3.74 / $10.05
| Professional | | $2.70 | $3.74 | $10.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.18 / $3.53 / $34.43
| Facility | | $3.18 | $3.53 | $34.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.67 / $60.00 / $60.00
| Facility | | $6.67 | $60.00 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.30 / $1.81 / $5.70
| Professional | | $1.30 | $1.81 | $5.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.62 / $3.24 / $6.16
| Facility | | $2.62 | $3.24 | $6.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $2.80 / $3.43
| Professional | | $2.62 | $2.80 | $3.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.30 / $2.10 / $5.70
| Professional | | $1.30 | $2.10 | $5.70 |