- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.75 / $7.89 / $30.83
| Facility | | $5.75 | $7.89 | $30.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.32 / $5.64 / $6.03
| Professional | | $5.32 | $5.64 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.24 / $3.88 / $3.88
| Professional | | $3.24 | $3.88 | $3.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.38 / $6.95 / $16.64
| Facility | | $4.38 | $6.95 | $16.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.28 / $7.42 / $9.67
| Professional | | $4.28 | $7.42 | $9.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.50 / $4.50 / $6.77
| Facility | | $4.50 | $4.50 | $6.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.88 / $4.53 / $9.06
| Professional | | $3.88 | $4.53 | $9.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $3.41 / $4.26
| Professional | | $3.10 | $3.41 | $4.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.47 / $6.47 / $9.69
| Facility | | $6.47 | $6.47 | $9.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $3.80 / $9.03
| Professional | | $2.25 | $3.80 | $9.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.35 / $3.88 / $3.88
| Professional | | $3.35 | $3.88 | $3.88 |