- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.43 / $95.76 / $250.80
| Facility | | $6.43 | $95.76 | $250.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.21 / $4.96 / $27.52
| Professional | | $3.21 | $4.96 | $27.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.42 / $23.63 / $38.36
| Facility | | $6.42 | $23.63 | $38.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $3.50 / $4.01
| Professional | | $2.63 | $3.50 | $4.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.78 / $2.78 / $2.78
| Facility | | $2.78 | $2.78 | $2.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.65 / $4.96 / $7.89
| Professional | | $2.65 | $4.96 | $7.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $2.35 / $2.35
| Professional | | $2.35 | $2.35 | $2.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.79 / $5.14 / $8.33
| Facility | | $3.79 | $5.14 | $8.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.28 / $4.28 / $7.89
| Professional | | $4.28 | $4.28 | $7.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.57 / $5.22 / $7.24
| Facility | | $3.57 | $5.22 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.80 / $2.52 / $2.61
| Professional | | $1.80 | $2.52 | $2.61 |