- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.02 / $56.58 / $550.51
| Facility | | $13.02 | $56.58 | $550.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.30 / $8.83 / $9.71
| Professional | | $3.30 | $8.83 | $9.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.00 / $3.20 / $10.86
| Facility | | $3.00 | $3.20 | $10.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.51 / $9.09 / $9.09
| Professional | | $5.51 | $9.09 | $9.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.03 / $5.00 / $9.18
| Facility | | $0.03 | $5.00 | $9.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.50 / $1.88 / $3.26
| Professional | | $1.50 | $1.88 | $3.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.50 / $3.00 / $4.33
| Professional | | $1.50 | $3.00 | $4.33 |