- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.74 / $17.22 / $110.86
| Facility | | $5.74 | $17.22 | $110.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.71 / $5.14 / $5.42
| Professional | | $4.71 | $5.14 | $5.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.53 / $5.25 / $17.22
| Facility | | $4.53 | $5.25 | $17.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.72 / $2.72 / $3.96
| Professional | | $2.72 | $2.72 | $3.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.74 / $6.31 / $8.03
| Facility | | $5.74 | $6.31 | $8.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.73 / $6.03 / $7.75
| Professional | | $3.73 | $6.03 | $7.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.21 / $5.74 / $15.10
| Facility | | $4.21 | $5.74 | $15.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.78 / $6.61 / $12.86
| Professional | | $3.78 | $6.61 | $12.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.74 / $5.74 / $6.99
| Facility | | $5.74 | $5.74 | $6.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $3.44 / $5.74
| Professional | | $2.41 | $3.44 | $5.74 |