- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $18.62 / $77.62
| Facility | | $7.94 | $18.62 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $5.13 / $25.70
| Professional | | $3.98 | $5.13 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $8.13 / $100.00
| Facility | | $5.25 | $8.13 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $5.75 / $12.30
| Professional | | $3.47 | $5.75 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.48 / $14.45 / $22.91
| Facility | | $11.48 | $14.45 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.37 / $5.37 / $7.41
| Professional | | $5.37 | $5.37 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.47 / $9.12 / $22.39
| Facility | | $4.47 | $9.12 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $7.08 / $10.00
| Professional | | $4.17 | $7.08 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $3,630.78 / $9,772.37
| Facility | | $8.32 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $8.32 / $10.00
| Professional | | $8.32 | $8.32 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $5.75 / $17.38
| Professional | | $5.75 | $5.75 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.37 / $7.59 / $19.05
| Facility | | $5.37 | $7.59 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $8.13 / $100.00
| Facility | | $5.25 | $8.13 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $5.75 / $12.30
| Professional | | $3.47 | $5.75 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $5.75 / $9.77
| Facility | | $3.31 | $5.75 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.88 / $4.79 / $13.80
| Professional | | $2.88 | $4.79 | $13.80 |