- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.98 / $6.00 / $23.32
| Facility | | $2.98 | $6.00 | $23.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $2.92 / $3.43
| Professional | | $2.54 | $2.92 | $3.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.43 / $3.43 / $8.92
| Facility | | $3.43 | $3.43 | $8.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.70 / $2.06 / $7.31
| Professional | | $1.70 | $2.06 | $7.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.06 / $3.43 / $3.43
| Facility | | $2.06 | $3.43 | $3.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.50 / $3.43 / $3.43
| Professional | | $2.50 | $3.43 | $3.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.40 / $7.19 / $36.94
| Facility | | $2.40 | $7.19 | $36.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.60 / $4.13 / $16.53
| Professional | | $2.60 | $4.13 | $16.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.50 / $4.46 / $332.00
| Facility | | $1.50 | $4.46 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.37 / $2.06 / $6.28
| Professional | | $1.37 | $2.06 | $6.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $3.30 / $3.85
| Professional | | $2.35 | $3.30 | $3.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.25 / $2.50 / $2.70
| Facility | | $2.25 | $2.50 | $2.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.23 / $8.52 / $50.00
| Facility | | $4.23 | $8.52 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.76 / $4.86 / $7.21
| Professional | | $2.76 | $4.86 | $7.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.44 / $2.06 / $5.15
| Professional | | $1.44 | $2.06 | $5.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.94 / $3.94 / $9.61
| Facility | | $3.94 | $3.94 | $9.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $3.43 / $4.12
| Professional | | $2.35 | $3.43 | $4.12 |