- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $9.55 / $158.49
| Facility | | $3.31 | $9.55 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.02 / $5.89
| Professional | | $3.02 | $3.02 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.98 / $3.98 / $3.98
| Facility | | $3.98 | $3.98 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.24 / $3.24 / $4.07
| Professional | | $3.24 | $3.24 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $5.13 / $8.91
| Facility | | $3.24 | $5.13 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.24 / $5.25 / $5.89
| Professional | | $3.24 | $5.25 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.16 / $3.16 / $7.08
| Facility | | $3.16 | $3.16 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $6.31 / $6.31
| Professional | | $1.86 | $6.31 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $4.17 / $100.00
| Facility | | $3.24 | $4.17 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $3.24 / $4.17
| Professional | | $2.14 | $3.24 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $54.95 / $89.13
| Professional | | $3.02 | $54.95 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.24 / $3.72 / $11.75
| Professional | | $3.24 | $3.72 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $85.11 / $100.00
| Facility | | $3.24 | $85.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.24 / $3.24 / $3.24
| Professional | | $3.24 | $3.24 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.27 / $4.27 / $5.25
| Professional | | $4.27 | $4.27 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $1.00 / $2.51
| Facility | | $0.02 | $1.00 | $2.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.29 / $3.24 / $3.98
| Professional | | $1.29 | $3.24 | $3.98 |