- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.32 / $15.68 / $42.54
| Facility | | $3.32 | $15.68 | $42.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $3.10 / $30.22
| Professional | | $3.10 | $3.10 | $30.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.37 / $26.57 / $51.82
| Facility | | $20.37 | $26.57 | $51.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.56 / $7.13 / $7.71
| Professional | | $3.56 | $7.13 | $7.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.51 / $7.23 / $11.42
| Professional | | $4.51 | $7.23 | $11.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.82 / $7.38 / $100.00
| Facility | | $2.82 | $7.38 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.82 / $4.70 / $9.40
| Professional | | $2.82 | $4.70 | $9.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.51 / $8.19 / $13.69
| Facility | | $4.51 | $8.19 | $13.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.65 / $8.61 / $12.27
| Professional | | $5.65 | $8.61 | $12.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.82 / $4.70 / $9.40
| Professional | | $2.82 | $4.70 | $9.40 |