- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.40 / $15.14 / $295.11
| Facility | | $4.40 | $15.14 | $295.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $2.83 / $6.98
| Professional | | $2.35 | $2.83 | $6.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.59 / $2.20 / $2.43
| Professional | | $1.59 | $2.20 | $2.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.78 / $5.73 / $11.07
| Facility | | $1.78 | $5.73 | $11.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.84 / $2.67 / $3.81
| Professional | | $1.84 | $2.67 | $3.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.22 / $5.15 / $9.27
| Facility | | $2.22 | $5.15 | $9.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.91 / $3.72 / $4.65
| Professional | | $1.91 | $3.72 | $4.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.54 / $3.05 / $60.00
| Facility | | $2.54 | $3.05 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.90 / $2.66 / $3.17
| Professional | | $1.90 | $2.66 | $3.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.90 / $2.66 / $3.17
| Professional | | $1.90 | $2.66 | $3.17 |