- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.10 / $32.15 / $77.70
| Facility | | $7.10 | $32.15 | $77.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.89 / $4.51 / $5.18
| Professional | | $3.89 | $4.51 | $5.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.72 / $13.72 / $100.00
| Facility | | $4.72 | $13.72 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.11 / $5.18 / $12.62
| Professional | | $3.11 | $5.18 | $12.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.26 / $14.74 / $25.78
| Facility | | $9.26 | $14.74 | $25.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.87 / $4.87 / $6.62
| Professional | | $4.87 | $4.87 | $6.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.62 / $7.71 / $17.67
| Facility | | $3.62 | $7.71 | $17.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.12 / $5.72 / $8.59
| Professional | | $3.12 | $5.72 | $8.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.55 / $3,472.00 / $9,239.00
| Facility | | $19.55 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.47 / $7.47 / $8.77
| Professional | | $7.47 | $7.47 | $8.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.18 / $7.18 / $19.26
| Professional | | $5.18 | $7.18 | $19.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.09 / $6.75 / $52.62
| Facility | | $6.09 | $6.75 | $52.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.72 / $100.00 / $100.00
| Facility | | $13.72 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.49 / $3.15 / $10.92
| Professional | | $2.49 | $3.15 | $10.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.03 / $5.89 / $11.52
| Facility | | $5.03 | $5.89 | $11.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.03 / $5.34 / $6.55
| Professional | | $5.03 | $5.34 | $6.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $4.34 / $12.88
| Professional | | $2.57 | $4.34 | $12.88 |