- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.12 / $263.03 / $446.68
| Professional | | $1.12 | $263.03 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $0.71 / $56.23
| Facility | | $0.71 | $0.71 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.76 / $0.76 / $0.76
| Professional | | $0.76 | $0.76 | $0.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.62 / $0.71 / $0.71
| Facility | | $0.62 | $0.71 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.63 / $0.63 / $0.85
| Professional | | $0.63 | $0.63 | $0.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.72 / $0.72 / $25.70
| Professional | | $0.72 | $0.72 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.65 / $0.69 / $5.62
| Professional | | $0.65 | $0.69 | $5.62 |