- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.67 / $36.77 / $346.45
| Facility | | $16.67 | $36.77 | $346.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.83 / $15.00 / $75.00
| Professional | | $8.83 | $15.00 | $75.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.42 / $16.67 / $20.84
| Facility | | $7.42 | $16.67 | $20.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.23 / $10.08 / $12.80
| Professional | | $8.23 | $10.08 | $12.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.84 / $19.51 / $60.38
| Facility | | $10.84 | $19.51 | $60.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.42 / $19.41 / $24.26
| Professional | | $12.42 | $19.41 | $24.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.19 / $16.67 / $17.50
| Professional | | $0.19 | $16.67 | $17.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.73 / $5.73 / $5.73
| Professional | | $5.73 | $5.73 | $5.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $9.56 / $16.67
| Professional | | $7.00 | $9.56 | $16.67 |