- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.88 / $15.85 / $60.26
| Facility | | $2.88 | $15.85 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.31 / $11.22
| Professional | | $2.00 | $3.31 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.82 / $2.19 / $2.51
| Professional | | $1.82 | $2.19 | $2.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $5.01 / $5.01
| Professional | | $2.63 | $5.01 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.40 / $8.71 / $14.79
| Facility | | $2.40 | $8.71 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.62 / $2.82 / $5.62
| Professional | | $1.62 | $2.82 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $100.00
| Facility | | $60.26 | $60.26 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.31 / $3.31 / $3.31
| Professional | | $3.31 | $3.31 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.32 / $3.09 / $3.63
| Facility | | $1.32 | $3.09 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.55 / $2.40 / $4.57
| Professional | | $1.55 | $2.40 | $4.57 |