- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.22 / $10.28 / $15.28
| Facility | | $8.22 | $10.28 | $15.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $6.51 / $26.91
| Professional | | $5.62 | $6.51 | $26.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.73 / $17.80 / $18.84
| Facility | | $14.73 | $17.80 | $18.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.38 / $3.38 / $28.35
| Professional | | $3.38 | $3.38 | $28.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.67 / $18.59 / $19.32
| Facility | | $4.67 | $18.59 | $19.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.92 / $22.11 / $33.92
| Facility | | $18.92 | $22.11 | $33.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.85 / $18.45 / $20.96
| Professional | | $7.85 | $18.45 | $20.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.10 / $6.10 / $8.22
| Facility | | $6.10 | $6.10 | $8.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.62 / $6.17 / $100.00
| Facility | | $5.62 | $6.17 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.11 / $6.85 / $18.97
| Professional | | $4.11 | $6.85 | $18.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.84 / $18.91 / $85.00
| Professional | | $5.84 | $18.91 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.10 / $6.10 / $8.22
| Facility | | $6.10 | $6.10 | $8.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.36 / $16.63 / $63.68
| Professional | | $8.36 | $16.63 | $63.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.70 / $13.70 / $100.00
| Facility | | $13.70 | $13.70 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.63 / $4.57 / $6.80
| Professional | | $3.63 | $4.57 | $6.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.04 / $7.04 / $14.59
| Professional | | $7.04 | $7.04 | $14.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.04 / $27.29 / $37.40
| Professional | | $7.04 | $27.29 | $37.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.43 / $5.48 / $6.85
| Facility | | $3.43 | $5.48 | $6.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.11 / $5.78 / $18.97
| Professional | | $4.11 | $5.78 | $18.97 |