- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $15.49 / $37.15
| Facility | | $5.89 | $15.49 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $5.01 / $26.30
| Professional | | $3.98 | $5.01 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.37 / $8.32 / $100.00
| Facility | | $5.37 | $8.32 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $5.89 / $12.30
| Professional | | $3.55 | $5.89 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.48 / $14.45 / $22.91
| Facility | | $11.48 | $14.45 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $5.50 / $7.59
| Professional | | $5.50 | $5.50 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.57 / $9.33 / $22.91
| Facility | | $4.57 | $9.33 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.37 / $7.08 / $10.00
| Professional | | $4.37 | $7.08 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $3,630.78 / $9,772.37
| Facility | | $6.31 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $8.32 / $10.00
| Professional | | $8.32 | $8.32 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.89 / $5.89 / $17.78
| Professional | | $5.89 | $5.89 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.62 / $7.08 / $20.89
| Facility | | $5.62 | $7.08 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.37 / $8.32 / $100.00
| Facility | | $5.37 | $8.32 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $5.89 / $12.30
| Professional | | $3.55 | $5.89 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.39 / $5.89 / $9.77
| Facility | | $3.39 | $5.89 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $4.90 / $14.13
| Professional | | $2.95 | $4.90 | $14.13 |