- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.81 / $37.14 / $102.60
| Facility | | $7.81 | $37.14 | $102.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.69 / $5.35 / $9.01
| Professional | | $4.69 | $5.35 | $9.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.61 / $4.17 / $11.12
| Professional | | $3.61 | $4.17 | $11.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $12.02 / $100.00
| Facility | | $6.31 | $12.02 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.97 / $5.47 / $10.35
| Professional | | $2.97 | $5.47 | $10.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.16 / $12.32 / $27.93
| Facility | | $4.16 | $12.32 | $27.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.13 / $7.72 / $12.17
| Professional | | $4.13 | $7.72 | $12.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.28 / $5.80 / $6.38
| Professional | | $4.28 | $5.80 | $6.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.01 / $6.31 / $13.27
| Facility | | $6.01 | $6.31 | $13.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.01 / $9.02 / $16.53
| Facility | | $6.01 | $9.02 | $16.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.41 / $5.41 / $5.41
| Professional | | $5.41 | $5.41 | $5.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.91 / $9.92 / $16.53
| Facility | | $6.91 | $9.92 | $16.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.51 / $6.01 / $16.17
| Professional | | $4.51 | $6.01 | $16.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.91 / $5.71 / $6.01
| Facility | | $3.91 | $5.71 | $6.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $2.52 / $6.01
| Professional | | $2.52 | $2.52 | $6.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.70 / $2.70 / $3.11
| Professional | | $2.70 | $2.70 | $3.11 |