- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.88 / $16.50 / $62.60
| Facility | | $2.88 | $16.50 | $62.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.14 / $4.55
| Professional | | $2.06 | $2.14 | $4.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $1.64 / $1.64
| Professional | | $1.42 | $1.64 | $1.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.86 / $6.55 / $9.73
| Facility | | $5.86 | $6.55 | $9.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.34 / $3.76 / $3.76
| Professional | | $3.34 | $3.76 | $3.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.55 / $3.04 / $13.12
| Facility | | $1.55 | $3.04 | $13.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.52 / $3.15 / $7.00
| Professional | | $1.52 | $3.15 | $7.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.14 / $2.14 / $11.95
| Facility | | $2.14 | $2.14 | $11.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $2.37 / $4.83
| Professional | | $1.42 | $2.37 | $4.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $2.37 / $4.93
| Professional | | $1.42 | $2.37 | $4.93 |