- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.73 / $5.11 / $46.75
| Facility | | $2.73 | $5.11 | $46.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $2.72 / $4.00
| Professional | | $2.61 | $2.72 | $4.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.51 / $10.09 / $14.63
| Facility | | $7.51 | $10.09 | $14.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.46 / $3.46 / $3.64
| Professional | | $3.46 | $3.46 | $3.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.06 / $2.54 / $4.88
| Facility | | $2.06 | $2.54 | $4.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.59 / $2.92 / $5.16
| Professional | | $1.59 | $2.92 | $5.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.65 / $2.88 / $60.00
| Facility | | $2.65 | $2.88 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.53 / $1.76 / $4.19
| Professional | | $1.53 | $1.76 | $4.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.31 / $3.64 / $18.55
| Facility | | $1.31 | $3.64 | $18.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.53 / $1.73 / $2.57
| Professional | | $1.53 | $1.73 | $2.57 |