- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.37 / $8.91 / $28.84
| Facility | | $5.37 | $8.91 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.98 / $6.46
| Professional | | $3.02 | $3.98 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $3.47 / $8.32
| Professional | | $3.47 | $3.47 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.57 / $10.00 / $21.38
| Facility | | $4.57 | $10.00 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $4.47 / $7.24
| Professional | | $3.02 | $4.47 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $2.29 / $5.25
| Professional | | $1.86 | $2.29 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.68 / $10,471.29 / $25,118.86
| Facility | | $4.68 | $10,471.29 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $4.17 / $5.13
| Professional | | $2.75 | $4.17 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.19 / $4.68 / $9.55
| Facility | | $2.19 | $4.68 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $2.75 / $6.76
| Professional | | $1.86 | $2.75 | $6.76 |