- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.04 / $163.10 / $1,941.73
| Facility | | $18.04 | $163.10 | $1,941.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.50 / $5.87 / $7.01
| Professional | | $4.50 | $5.87 | $7.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.26 / $8.61 / $14.22
| Facility | | $8.26 | $8.61 | $14.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.26 / $5.26 / $13.34
| Professional | | $5.26 | $5.26 | $13.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.51 / $16.73 / $29.41
| Facility | | $6.51 | $16.73 | $29.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $7.75 / $10.33
| Professional | | $5.01 | $7.75 | $10.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.94 / $5.12 / $11.22
| Professional | | $2.94 | $5.12 | $11.22 |