- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.18 / $45.57 / $58.19
| Facility | | $5.18 | $45.57 | $58.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $4.51 / $6.66
| Professional | | $2.75 | $4.51 | $6.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.11 / $3.11 / $3.11
| Professional | | $3.11 | $3.11 | $3.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.41 / $16.66 / $24.14
| Facility | | $12.41 | $16.66 | $24.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.92 / $4.92 / $5.29
| Professional | | $4.92 | $4.92 | $5.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.37 / $3.62 / $8.44
| Facility | | $3.37 | $3.62 | $8.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.05 / $5.30 / $7.23
| Professional | | $3.05 | $5.30 | $7.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.69 / $4.69 / $100.00
| Facility | | $4.69 | $4.69 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $2.96 / $6.48
| Professional | | $2.18 | $2.96 | $6.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $2.49 / $3.37
| Professional | | $2.18 | $2.49 | $3.37 |