- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.55 / $43.78 / $732.15
| Facility | | $6.55 | $43.78 | $732.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.33 / $5.70 / $18.68
| Professional | | $3.33 | $5.70 | $18.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.21 / $12.35 / $13.06
| Facility | | $10.21 | $12.35 | $13.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $2.34 / $19.66
| Professional | | $2.34 | $2.34 | $19.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.62 / $12.88 / $13.39
| Facility | | $3.62 | $12.88 | $13.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.75 / $4.75 / $4.75
| Professional | | $4.75 | $4.75 | $4.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.52 / $15.80 / $24.23
| Facility | | $13.52 | $15.80 | $24.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $12.79 / $14.54
| Professional | | $5.78 | $12.79 | $14.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.23 / $4.23 / $5.70
| Facility | | $4.23 | $4.23 | $5.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.90 / $4.47 / $100.00
| Facility | | $3.90 | $4.47 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.85 / $4.75 / $13.16
| Professional | | $2.85 | $4.75 | $13.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.38 / $13.11 / $85.00
| Professional | | $2.38 | $13.11 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.23 / $4.23 / $5.70
| Facility | | $4.23 | $4.23 | $5.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.80 / $11.88 / $49.41
| Professional | | $5.80 | $11.88 | $49.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.50 / $9.50 / $100.00
| Facility | | $9.50 | $9.50 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $3.10 / $4.70
| Professional | | $2.52 | $3.10 | $4.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.11 / $10.11 / $11.33
| Professional | | $10.11 | $10.11 | $11.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.33 / $11.33 / $25.94
| Professional | | $11.33 | $11.33 | $25.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.76 / $4.01 / $13.02
| Professional | | $2.76 | $4.01 | $13.02 |