- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $6.00 / $10.02
| Professional | | $1.93 | $6.00 | $10.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.08 / $1.08 / $1.08
| Professional | | $1.08 | $1.08 | $1.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.44 / $5.52 / $6.49
| Professional | | $4.44 | $5.52 | $6.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.94 / $2.63 / $31.31
| Facility | | $1.94 | $2.63 | $31.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.08 / $2.57 / $2.76
| Professional | | $2.08 | $2.57 | $2.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.37 / $2.63 / $2.89
| Facility | | $2.37 | $2.63 | $2.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.94 / $2.50 / $25.14
| Facility | | $1.94 | $2.50 | $25.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.08 / $2.29 / $2.83
| Professional | | $1.08 | $2.29 | $2.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $2.89 / $2.89
| Professional | | $2.75 | $2.89 | $2.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.12 / $2.13
| Professional | | $1.07 | $1.12 | $2.13 |