- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.75 / $10.14 / $30.54
| Facility | | $2.75 | $10.14 | $30.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $2.69 / $3.60
| Professional | | $2.62 | $2.69 | $3.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $2.09 / $2.09
| Professional | | $2.09 | $2.09 | $2.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.69 / $6.63 / $11.04
| Facility | | $1.69 | $6.63 | $11.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.75 / $2.54 / $3.63
| Professional | | $1.75 | $2.54 | $3.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.10 / $4.90 / $8.82
| Facility | | $2.10 | $4.90 | $8.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.72 / $4.65
| Professional | | $2.00 | $3.72 | $4.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $2.73 / $100.00
| Facility | | $2.27 | $2.73 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.27 / $1.76 / $2.47
| Professional | | $1.27 | $1.76 | $2.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.27 / $1.76 / $2.42
| Professional | | $1.27 | $1.76 | $2.42 |