- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.32 / $10.69 / $25.36
| Facility | | $5.32 | $10.69 | $25.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.80 / $6.40 / $11.60
| Professional | | $4.80 | $6.40 | $11.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.31 / $8.72 / $27.68
| Facility | | $5.31 | $8.72 | $27.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $3.20 / $12.81
| Professional | | $2.40 | $3.20 | $12.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.34 / $8.00 / $12.80
| Facility | | $5.34 | $8.00 | $12.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.55 / $17.60 / $25.10
| Facility | | $7.55 | $17.60 | $25.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.67 / $9.91 / $12.39
| Professional | | $3.67 | $9.91 | $12.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.74 / $10.40 / $21.42
| Professional | | $8.74 | $10.40 | $21.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $4.80 / $16.80
| Professional | | $3.50 | $4.80 | $16.80 |