- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.42 / $37.61 / $106.09
| Facility | | $10.42 | $37.61 | $106.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.63 / $7.32 / $17.00
| Professional | | $5.63 | $7.32 | $17.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.38 / $5.38 / $5.38
| Professional | | $5.38 | $5.38 | $5.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.74 / $15.46 / $25.23
| Facility | | $8.74 | $15.46 | $25.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $9.47 / $11.13
| Professional | | $6.46 | $9.47 | $11.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.61 / $35.70 / $35.70
| Facility | | $8.61 | $35.70 | $35.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.60 / $16.75 / $39.36
| Facility | | $5.60 | $16.75 | $39.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $4.32 / $12.39
| Professional | | $4.05 | $4.32 | $12.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.62 / $5.54 / $12.92
| Professional | | $3.62 | $5.54 | $12.92 |