- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.68 / $76.05 / $446.17
| Facility | | $9.68 | $76.05 | $446.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $6.60 / $9.18
| Professional | | $3.47 | $6.60 | $9.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.23 / $5.88 / $14.81
| Professional | | $4.23 | $5.88 | $14.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.14 / $13.14 / $19.60
| Facility | | $11.14 | $13.14 | $19.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $12.43 / $12.43
| Professional | | $5.50 | $12.43 | $12.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.57 / $10.88 / $46.69
| Facility | | $5.57 | $10.88 | $46.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.17 / $11.87 / $20.00
| Professional | | $5.17 | $11.87 | $20.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.85 / $6.85 / $69.89
| Facility | | $6.85 | $6.85 | $69.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $5.08 / $15.82
| Professional | | $3.55 | $5.08 | $15.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $5.08 / $17.60
| Professional | | $3.55 | $5.08 | $17.60 |