- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.35 / $46.17 / $82.72
| Facility | | $37.35 | $46.17 | $82.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.60 / $5.79 / $7.79
| Professional | | $5.60 | $5.79 | $7.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.80 / $13.12 / $14.65
| Professional | | $9.80 | $13.12 | $14.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.43 / $7.51 / $9.44
| Professional | | $7.43 | $7.51 | $9.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.51 / $40.20 / $100.00
| Facility | | $6.51 | $40.20 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $7.81 / $13.02
| Professional | | $3.26 | $7.81 | $13.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $4.55 / $11.16
| Professional | | $2.73 | $4.55 | $11.16 |