- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.12 / $10.62 / $14.24
| Facility | | $5.12 | $10.62 | $14.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.14 / $3.66 / $30.54
| Professional | | $3.14 | $3.66 | $30.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.70 / $9.14 / $11.42
| Professional | | $5.70 | $9.14 | $11.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.75 / $8.17 / $54.27
| Professional | | $4.75 | $8.17 | $54.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.75 / $6.41 / $17.73
| Facility | | $4.75 | $6.41 | $17.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.84 / $4.88 / $12.01
| Professional | | $2.84 | $4.88 | $12.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.70 / $8.86 / $12.19
| Facility | | $5.70 | $8.86 | $12.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.64 / $8.99 / $12.19
| Professional | | $5.64 | $8.99 | $12.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.85 / $2.85 / $21.43
| Professional | | $2.85 | $2.85 | $21.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.75 / $4.75 / $4.75
| Professional | | $3.75 | $4.75 | $4.75 |