- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.36 / $67.45 / $240.35
| Facility | | $17.36 | $67.45 | $240.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.92 / $4.51 / $31.15
| Professional | | $3.92 | $4.51 | $31.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.78 / $9.78 / $9.78
| Facility | | $9.78 | $9.78 | $9.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $9.14 / $11.42
| Professional | | $5.78 | $9.14 | $11.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.80 / $8.03 / $60.00
| Facility | | $4.80 | $8.03 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.01 / $3.51 / $7.02
| Professional | | $3.01 | $3.51 | $7.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.47 / $10.21 / $15.74
| Facility | | $6.47 | $10.21 | $15.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.47 / $11.00 / $14.36
| Professional | | $6.47 | $11.00 | $14.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $11.72 / $13.79
| Professional | | $7.00 | $11.72 | $13.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $3.51 / $6.02
| Professional | | $2.11 | $3.51 | $6.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $5.01 / $5.01
| Professional | | $5.01 | $5.01 | $5.01 |