- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.88 / $10.96 / $121.80
| Facility | | $7.88 | $10.96 | $121.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.55 / $10.96 / $13.36
| Professional | | $10.55 | $10.96 | $13.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $12.02 / $14.04
| Facility | | $8.32 | $12.02 | $14.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.44 / $6.60 / $13.23
| Professional | | $5.44 | $6.60 | $13.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.36 / $18.70 / $22.04
| Facility | | $13.36 | $18.70 | $22.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.30 / $17.37 / $26.72
| Professional | | $14.30 | $17.37 | $26.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.68 / $10.40 / $50.00
| Facility | | $8.68 | $10.40 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.77 / $15.03 / $75.28
| Professional | | $6.77 | $15.03 | $75.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.35 / $7.35 / $7.35
| Professional | | $7.35 | $7.35 | $7.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.61 / $11.20 / $21.40
| Professional | | $5.61 | $11.20 | $21.40 |