- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.77 / $10.03 / $66.83
| Facility | | $3.77 | $10.03 | $66.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.98 / $4.36 / $5.54
| Professional | | $2.98 | $4.36 | $5.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.50 / $3.01 / $3.48
| Professional | | $2.50 | $3.01 | $3.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.41 / $16.66 / $24.14
| Facility | | $12.41 | $16.66 | $24.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.76 / $4.76 / $5.12
| Professional | | $4.76 | $4.76 | $5.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.26 / $3.51 / $8.19
| Facility | | $3.26 | $3.51 | $8.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.31 / $5.04 / $7.23
| Professional | | $2.31 | $5.04 | $7.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.38 / $4.83 / $60.00
| Facility | | $4.38 | $4.83 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.87 / $6.28
| Professional | | $2.11 | $2.87 | $6.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.67 / $21.67 / $30.99
| Facility | | $21.67 | $21.67 | $30.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.50 / $3.26
| Professional | | $2.11 | $2.50 | $3.26 |