- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $14.79 / $56.23
| Facility | | $5.25 | $14.79 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $5.01 / $25.12
| Professional | | $3.98 | $5.01 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.13 / $7.76 / $100.00
| Facility | | $5.13 | $7.76 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $5.62 / $11.75
| Professional | | $3.16 | $5.62 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $13.49 / $21.88
| Facility | | $10.96 | $13.49 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $5.25 / $7.08
| Professional | | $5.25 | $5.25 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.37 / $8.91 / $21.38
| Facility | | $4.37 | $8.91 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $6.61 / $9.55
| Professional | | $4.17 | $6.61 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.46 / $3,630.78 / $9,772.37
| Facility | | $6.46 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $7.94 / $9.33
| Professional | | $7.94 | $7.94 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $5.62 / $16.98
| Professional | | $5.62 | $5.62 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $6.61 / $14.45
| Facility | | $5.25 | $6.61 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.13 / $7.76 / $100.00
| Facility | | $5.13 | $7.76 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $5.62 / $11.75
| Professional | | $3.16 | $5.62 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $5.62 / $9.33
| Facility | | $3.24 | $5.62 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $4.68 / $11.75
| Professional | | $2.75 | $4.68 | $11.75 |