- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.35 / $10.58 / $15.52
| Facility | | $5.35 | $10.58 | $15.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.58 / $4.23 / $4.86
| Professional | | $2.58 | $4.23 | $4.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.72 / $13.15 / $19.48
| Facility | | $11.72 | $13.15 | $19.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $7.76 / $19.78
| Professional | | $7.76 | $7.76 | $19.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.20 / $6.25 / $27.72
| Facility | | $3.20 | $6.25 | $27.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.04 / $7.23 / $15.00
| Professional | | $3.04 | $7.23 | $15.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.23 / $4.23 / $10.52
| Facility | | $4.23 | $4.23 | $10.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $3.59 / $9.91
| Professional | | $2.04 | $3.59 | $9.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.75 / $4.86 / $7.29
| Facility | | $1.75 | $4.86 | $7.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $3.97 / $11.83
| Professional | | $2.10 | $3.97 | $11.83 |