- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.51 / $11.97 / $14.02
| Facility | | $3.51 | $11.97 | $14.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.84 / $13.04 / $13.04
| Professional | | $10.84 | $13.04 | $13.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.93 / $13.11 / $36.47
| Facility | | $10.93 | $13.11 | $36.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.71 / $9.77 / $10.60
| Professional | | $4.71 | $9.77 | $10.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $12.39 / $42.70
| Facility | | $2.50 | $12.39 | $42.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.78 / $23.23
| Professional | | $2.37 | $2.78 | $23.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.00 / $11.87 / $13.98
| Facility | | $3.00 | $11.87 | $13.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.70 / $5.18 / $7.00
| Professional | | $2.70 | $5.18 | $7.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $4.94 / $9.77
| Professional | | $2.47 | $4.94 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.94 / $77.43 / $100.00
| Facility | | $39.94 | $77.43 | $100.00 |