- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.28 / $76.20 / $626.40
| Facility | | $4.28 | $76.20 | $626.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.08 / $69.75 / $177.45
| Professional | | $9.08 | $69.75 | $177.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.25 / $4.70 / $5.49
| Facility | | $3.25 | $4.70 | $5.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.58 / $2.96 / $5.54
| Professional | | $2.58 | $2.96 | $5.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.22 / $6.26 / $7.31
| Facility | | $5.22 | $6.26 | $7.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.22 / $6.31 / $10.44
| Professional | | $5.22 | $6.31 | $10.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.39 / $4.05 / $12.44
| Facility | | $3.39 | $4.05 | $12.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $5.87 / $34.89
| Professional | | $2.64 | $5.87 | $34.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.87 / $2.87 / $2.87
| Professional | | $2.87 | $2.87 | $2.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $4.20 / $7.30
| Professional | | $2.19 | $4.20 | $7.30 |