- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $25.70 / $104.71
| Facility | | $8.32 | $25.70 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $4.68 / $14.79
| Professional | | $3.98 | $4.68 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.68 / $7.24 / $100.00
| Facility | | $4.68 | $7.24 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.09 / $5.13 / $10.96
| Professional | | $3.09 | $5.13 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.23 / $12.88 / $20.42
| Facility | | $10.23 | $12.88 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.90 / $4.90 / $6.61
| Professional | | $4.90 | $4.90 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.07 / $8.32 / $19.95
| Facility | | $4.07 | $8.32 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $6.17 / $8.51
| Professional | | $3.80 | $6.17 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.62 / $3,630.78 / $9,772.37
| Facility | | $5.62 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $7.41 / $8.71
| Professional | | $7.41 | $7.41 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.13 / $5.13 / $15.85
| Professional | | $5.13 | $5.13 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $7.08 / $58.88
| Facility | | $6.31 | $7.08 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.68 / $7.24 / $100.00
| Facility | | $4.68 | $7.24 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.09 / $5.13 / $10.96
| Professional | | $3.09 | $5.13 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.57 / $6.17 / $8.32
| Facility | | $4.57 | $6.17 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $5.37 / $7.76
| Professional | | $4.57 | $5.37 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.95 / $5.13 / $8.71
| Facility | | $2.95 | $5.13 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $4.37 / $12.30
| Professional | | $2.57 | $4.37 | $12.30 |