- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.18 / $8.35 / $16.71
| Facility | | $4.18 | $8.35 | $16.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.18 / $6.68 / $35.82
| Professional | | $4.18 | $6.68 | $35.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.02 / $36.86 / $59.87
| Facility | | $10.02 | $36.86 | $59.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.42 / $4.55 / $5.24
| Professional | | $3.42 | $4.55 | $5.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.62 / $3.62 / $3.62
| Facility | | $3.62 | $3.62 | $3.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.58 / $6.20 / $10.36
| Professional | | $3.58 | $6.20 | $10.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.06 / $3.06 / $3.06
| Professional | | $3.06 | $3.06 | $3.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.96 / $6.68 / $10.91
| Facility | | $4.96 | $6.68 | $10.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.57 / $5.57 / $10.36
| Professional | | $5.57 | $5.57 | $10.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $3.29 / $3.42
| Professional | | $2.34 | $3.29 | $3.42 |