- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.91 / $6.10 / $20.89
| Facility | | $1.91 | $6.10 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.16 / $2.27 / $4.32
| Professional | | $2.16 | $2.27 | $4.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.52 / $1.52 / $1.52
| Professional | | $1.52 | $1.52 | $1.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.47 / $23.46 / $33.97
| Facility | | $17.47 | $23.46 | $33.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $2.54
| Professional | | $2.41 | $2.41 | $2.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.65 / $1.77 / $4.13
| Facility | | $1.65 | $1.77 | $4.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.14 / $2.65 / $3.61
| Professional | | $1.14 | $2.65 | $3.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.29 / $2.29 / $100.00
| Facility | | $2.29 | $2.29 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.46 / $3.18
| Professional | | $1.07 | $1.46 | $3.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.27 / $1.65
| Professional | | $1.07 | $1.27 | $1.65 |