- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.86 / $6.92 / $57.49
| Facility | | $3.86 | $6.92 | $57.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.78 / $5.22 / $9.80
| Professional | | $4.78 | $5.22 | $9.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.27 / $12.47 / $18.07
| Facility | | $9.27 | $12.47 | $18.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.48 / $5.48 / $5.48
| Professional | | $5.48 | $5.48 | $5.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.75 / $4.03 / $7.46
| Facility | | $3.75 | $4.03 | $7.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $5.83 / $8.26
| Professional | | $2.59 | $5.83 | $8.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.76 / $5.23 / $100.00
| Facility | | $4.76 | $5.23 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.63 / $2.69 / $6.80
| Professional | | $1.63 | $2.69 | $6.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.66 / $11.66 / $11.66
| Facility | | $11.66 | $11.66 | $11.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.63 / $2.69 / $5.77
| Professional | | $1.63 | $2.69 | $5.77 |