- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.56 / $646.00 / $4,865.81
| Facility | | $6.56 | $646.00 | $4,865.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $6.56 / $11.17
| Professional | | $6.50 | $6.56 | $11.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.84 / $14.72 / $29.20
| Facility | | $5.84 | $14.72 | $29.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $7.94 / $7.94
| Professional | | $7.94 | $7.94 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.66 / $9.10 / $1,705.89
| Facility | | $5.66 | $9.10 | $1,705.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.30 / $6.72 / $11.32
| Professional | | $6.30 | $6.72 | $11.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $984.68 / $984.68 / $984.68
| Facility | | $984.68 | $984.68 | $984.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.13 / $6.25 / $6.25
| Facility | | $6.13 | $6.25 | $6.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.25 / $6.25 / $6.25
| Professional | | $6.25 | $6.25 | $6.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $1,713.23 / $1,713.23
| Facility | | $100.00 | $1,713.23 | $1,713.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.48 / $9.30 / $32.76
| Facility | | $5.48 | $9.30 | $32.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.88 / $6.50 / $11.72
| Professional | | $4.88 | $6.50 | $11.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.13 / $6.25 / $9.30
| Facility | | $6.13 | $6.25 | $9.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.11 / $6.25 / $11.71
| Professional | | $6.11 | $6.25 | $11.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $6.50 / $6.50
| Professional | | $6.50 | $6.50 | $6.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.47 / $6.47 / $8.77
| Professional | | $6.47 | $6.47 | $8.77 |