- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.39 / $25.17 / $97.14
| Facility | | $8.39 | $25.17 | $97.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.62 / $4.68 / $9.24
| Professional | | $4.62 | $4.68 | $9.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.72 / $13.92 / $100.00
| Facility | | $4.72 | $13.92 | $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
- $17.86 / $3,472.00 / $9,239.00
| Facility | | $17.86 | $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 / $6.77 / $52.77
| Facility | | $6.09 | $6.77 | $52.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.92 / $100.00 / $100.00
| Facility | | $13.92 | $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
- $5.01 / $6.22 / $11.81
| Facility | | $5.01 | $6.22 | $11.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $3.63 / $9.26
| Professional | | $2.57 | $3.63 | $9.26 |