- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.88 / $23.85 / $32.72
| Facility | | $10.88 | $23.85 | $32.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.66 / $7.77 / $10.13
| Professional | | $6.66 | $7.77 | $10.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.56 / $18.28 / $22.85
| Professional | | $11.56 | $18.28 | $22.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.09 / $17.66 / $36.61
| Professional | | $10.09 | $17.66 | $36.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.09 / $13.12 / $37.59
| Facility | | $10.09 | $13.12 | $37.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.05 / $10.09 / $23.21
| Professional | | $6.05 | $10.09 | $23.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.43 / $18.51 / $27.39
| Facility | | $9.43 | $18.51 | $27.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.65 / $18.16 / $26.33
| Professional | | $11.65 | $18.16 | $26.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.05 / $6.05 / $21.52
| Professional | | $6.05 | $6.05 | $21.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.97 / $10.09 / $10.09
| Professional | | $7.97 | $10.09 | $10.09 |