- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.33 / $14.00 / $20.30
| Facility | | $3.33 | $14.00 | $20.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.71 / $3.80 / $4.13
| Professional | | $3.71 | $3.80 | $4.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.09 / $11.14 / $68.33
| Facility | | $5.09 | $11.14 | $68.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.75 / $6.00 / $6.66
| Professional | | $4.75 | $6.00 | $6.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.64 / $13.78 / $38.22
| Facility | | $8.64 | $13.78 | $38.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $3.06 / $7.23
| Professional | | $2.47 | $3.06 | $7.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.78 / $4.08 / $9.08
| Facility | | $2.78 | $4.08 | $9.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.76 / $0.84 / $5.00
| Professional | | $0.76 | $0.84 | $5.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $2.61 / $3.76
| Professional | | $2.61 | $2.61 | $3.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.77 / $2.85 / $5.70
| Professional | | $1.77 | $2.85 | $5.70 |