- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.30 / $24.00 / $60.25
| Facility | | $5.30 | $24.00 | $60.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.49 / $6.00 / $60.25
| Professional | | $4.49 | $6.00 | $60.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.27 / $22.60 / $293.00
| Facility | | $10.27 | $22.60 | $293.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.75 / $5.62 / $14.05
| Professional | | $3.75 | $5.62 | $14.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.00 / $46.33 / $92.28
| Facility | | $14.00 | $46.33 | $92.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.11 / $4.44 / $44.98
| Professional | | $3.11 | $4.44 | $44.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.03 / $12.30 / $30.21
| Facility | | $6.03 | $12.30 | $30.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.68 / $10.74 / $14.45
| Professional | | $3.68 | $10.74 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $10.31 / $99.00
| Professional | | $9.36 | $10.31 | $99.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.50 / $9.36 / $18.82
| Professional | | $7.50 | $9.36 | $18.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.00 / $80.00 / $80.00
| Facility | | $60.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.68 / $4.68 / $4.68
| Professional | | $4.68 | $4.68 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.69 / $8.90 / $22.40
| Facility | | $4.69 | $8.90 | $22.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.85 / $7.21 / $11.24
| Professional | | $3.85 | $7.21 | $11.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.88 / $32.88 / $32.88
| Professional | | $32.88 | $32.88 | $32.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.09 / $5.62 / $13.12
| Professional | | $4.09 | $5.62 | $13.12 |