- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.54 / $40.59 / $104.78
| Facility | | $7.54 | $40.59 | $104.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.97 / $6.78 / $32.35
| Professional | | $3.97 | $6.78 | $32.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $9.14 / $11.42
| Professional | | $5.78 | $9.14 | $11.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.16 / $9.02 / $20.00
| Professional | | $5.16 | $9.02 | $20.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.16 / $9.18 / $33.22
| Facility | | $5.16 | $9.18 | $33.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $5.16 / $13.30
| Professional | | $3.10 | $5.16 | $13.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.32 / $10.51 / $16.18
| Facility | | $6.32 | $10.51 | $16.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.19 / $10.51 / $14.78
| Professional | | $6.19 | $10.51 | $14.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.74 / $7.74 / $7.74
| Facility | | $7.74 | $7.74 | $7.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $4.32 / $13.05
| Professional | | $3.10 | $4.32 | $13.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.08 / $5.16 / $5.16
| Professional | | $4.08 | $5.16 | $5.16 |