- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.82 / $7.28 / $10.82
| Facility | | $5.82 | $7.28 | $10.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $4.61 / $14.50
| Professional | | $3.98 | $4.61 | $14.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.43 / $12.61 / $13.34
| Facility | | $10.43 | $12.61 | $13.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $1.94 / $19.79
| Professional | | $1.94 | $1.94 | $19.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.05 / $11.85 / $12.32
| Facility | | $3.05 | $11.85 | $12.32 |
- 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 / $13.06 / $14.84
| Professional | | $5.78 | $13.06 | $14.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.28 / $3.55 / $5.82
| Facility | | $3.28 | $3.55 | $5.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.28 / $3.98 / $100.00
| Facility | | $3.28 | $3.98 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $4.84 / $10.82
| Professional | | $2.81 | $4.84 | $10.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.43 / $7.28 / $85.00
| Professional | | $2.43 | $7.28 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.28 / $3.55 / $5.82
| Facility | | $3.28 | $3.55 | $5.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.55 / $11.88 / $29.66
| Professional | | $6.55 | $11.88 | $29.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.69 / $9.69 / $100.00
| Facility | | $9.69 | $9.69 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.47 / $3.66
| Professional | | $2.45 | $2.47 | $3.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $3.80 / $10.33
| Professional | | $3.80 | $3.80 | $10.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $3.80 / $26.48
| Professional | | $3.80 | $3.80 | $26.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.84 / $4.84 / $4.84
| Facility | | $4.84 | $4.84 | $4.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $3.88 / $9.13
| Professional | | $2.62 | $3.88 | $9.13 |