- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.78 / $21.83 / $21.83
| Facility | | $9.78 | $21.83 | $21.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.78 / $10.03 / $12.24
| Professional | | $9.78 | $10.03 | $12.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.73 / $10.19 / $12.36
| Professional | | $3.73 | $10.19 | $12.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.42 / $9.91 / $14.05
| Facility | | $5.42 | $9.91 | $14.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.25 / $7.71 / $10.40
| Professional | | $4.25 | $7.71 | $10.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.09 / $10.16 / $12.24
| Facility | | $4.09 | $10.16 | $12.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.94 / $2.94 / $2.94
| Professional | | $2.94 | $2.94 | $2.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.67 / $10.16 / $12.24
| Facility | | $3.67 | $10.16 | $12.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.19 / $11.35 / $673.81
| Professional | | $10.19 | $11.35 | $673.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.63 / $65.00 / $85.00
| Professional | | $36.63 | $65.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.67 / $9.91 / $12.24
| Facility | | $3.67 | $9.91 | $12.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.94 / $2.94 / $2.94
| Professional | | $2.94 | $2.94 | $2.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $8.30 / $12.49
| Professional | | $5.62 | $8.30 | $12.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.40 / $10.40 / $100.00
| Facility | | $10.40 | $10.40 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.40 / $12.97 / $673.81
| Professional | | $10.40 | $12.97 | $673.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.70 / $6.70 / $12.25
| Professional | | $6.70 | $6.70 | $12.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.19 / $10.51 / $12.14
| Professional | | $10.19 | $10.51 | $12.14 |