- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.27 / $12.61 / $1,716.80
| Facility | | $5.27 | $12.61 | $1,716.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.72 / $8.01 / $9.77
| Professional | | $7.72 | $8.01 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.80 / $8.78 / $10.27
| Facility | | $5.80 | $8.78 | $10.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.30 / $5.68 / $7.96
| Professional | | $4.30 | $5.68 | $7.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $11.72 / $15.63
| Facility | | $9.77 | $11.72 | $15.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.45 / $12.70 / $19.54
| Professional | | $10.45 | $12.70 | $19.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.35 / $7.60 / $12.06
| Facility | | $6.35 | $7.60 | $12.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.46 / $11.15 / $55.08
| Professional | | $4.46 | $11.15 | $55.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.37 / $5.37 / $5.37
| Professional | | $5.37 | $5.37 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.88 / $5.76 / $11.35
| Professional | | $4.88 | $5.76 | $11.35 |