- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.04 / $5.96 / $6.85
| Facility | | $3.04 | $5.96 | $6.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $3.10 / $5.09
| Professional | | $3.10 | $3.10 | $5.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.63 / $3.33 / $3.51
| Facility | | $2.63 | $3.33 | $3.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.27 / $3.41 / $3.50
| Professional | | $3.27 | $3.41 | $3.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.04 / $3.10 / $3.80
| Professional | | $3.04 | $3.10 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.45 / $5.78 / $95.00
| Facility | | $3.45 | $5.78 | $95.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.98 / $3.04 / $3.79
| Professional | | $2.98 | $3.04 | $3.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.35 / $3.57 / $4.45
| Facility | | $3.35 | $3.57 | $4.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.35 / $3.57 / $4.45
| Professional | | $3.35 | $3.57 | $4.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $3.10 / $3.41
| Professional | | $2.95 | $3.10 | $3.41 |