- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.75 / $65.05 / $133.88
| Facility | | $8.75 | $65.05 | $133.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.03 / $5.84 / $7.71
| Professional | | $5.03 | $5.84 | $7.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.35 / $3.35 / $10.58
| Professional | | $3.35 | $3.35 | $10.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.70 / $7.04 / $30.93
| Facility | | $6.70 | $7.04 | $30.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.31 / $6.00 / $18.02
| Professional | | $3.31 | $6.00 | $18.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.93 / $14.07 / $37.94
| Facility | | $8.93 | $14.07 | $37.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.96 / $6.67 / $10.16
| Professional | | $3.96 | $6.67 | $10.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.85 / $17.13 / $100.00
| Facility | | $5.85 | $17.13 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $4.76 / $8.16
| Professional | | $2.81 | $4.76 | $8.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.41 / $6.70 / $9.19
| Facility | | $2.41 | $6.70 | $9.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $4.46 / $9.36
| Professional | | $2.81 | $4.46 | $9.36 |