- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.25 / $58.04 / $354.02
| Facility | | $6.25 | $58.04 | $354.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.22 / $4.59 / $5.63
| Professional | | $4.22 | $4.59 | $5.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $3.07 / $3.56
| Professional | | $2.56 | $3.07 | $3.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.47 / $5.50 / $15.05
| Facility | | $3.47 | $5.50 | $15.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.46 / $5.78 / $7.75
| Professional | | $3.46 | $5.78 | $7.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.09 / $29.14 / $46.96
| Facility | | $5.09 | $29.14 | $46.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $7.09 / $8.44
| Professional | | $2.52 | $7.09 | $8.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.46 / $2.70 / $3.37
| Professional | | $2.46 | $2.70 | $3.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.96 / $7.16
| Professional | | $2.04 | $2.96 | $7.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.65 / $3.07 / $3.07
| Professional | | $2.65 | $3.07 | $3.07 |