- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.85 / $23.68 / $70.50
| Facility | | $5.85 | $23.68 | $70.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $3.84 / $5.12
| Professional | | $3.72 | $3.84 | $5.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.89 / $11.89 / $100.00
| Facility | | $3.89 | $11.89 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $4.26 / $10.40
| Professional | | $2.56 | $4.26 | $10.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.71 / $12.28 / $21.48
| Facility | | $7.71 | $12.28 | $21.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.01 / $4.01 / $5.46
| Professional | | $4.01 | $4.01 | $5.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.98 / $6.34 / $14.61
| Facility | | $2.98 | $6.34 | $14.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $4.72 / $7.40
| Professional | | $2.52 | $4.72 | $7.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.26 / $3,472.00 / $9,239.00
| Facility | | $13.26 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.07 / $6.07 / $7.14
| Professional | | $6.07 | $6.07 | $7.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.26 / $5.92 / $15.91
| Professional | | $4.26 | $5.92 | $15.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.03 / $5.65 / $27.67
| Facility | | $5.03 | $5.65 | $27.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.95 / $100.00 / $100.00
| Facility | | $11.95 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.86 / $9.02
| Professional | | $2.04 | $2.86 | $9.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.13 / $5.13 / $9.73
| Facility | | $4.13 | $5.13 | $9.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.77 / $4.40 / $5.40
| Professional | | $3.77 | $4.40 | $5.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $3.15 / $8.14
| Professional | | $2.04 | $3.15 | $8.14 |