- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.79 / $18.18 / $409.46
| Facility | | $5.79 | $18.18 | $409.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.40 / $3.56 / $6.82
| Professional | | $3.40 | $3.56 | $6.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.97 / $2.73 / $3.01
| Professional | | $1.97 | $2.73 | $3.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.20 / $7.67 / $13.71
| Facility | | $2.20 | $7.67 | $13.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $3.31 / $4.72
| Professional | | $2.27 | $3.31 | $4.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.74 / $6.38 / $11.48
| Facility | | $2.74 | $6.38 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.29 / $4.54 / $6.20
| Professional | | $2.29 | $4.54 | $6.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.14 / $3.55 / $100.00
| Facility | | $3.14 | $3.55 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.36 / $3.21 / $3.93
| Professional | | $2.36 | $3.21 | $3.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.36 / $3.23 / $3.93
| Professional | | $2.36 | $3.23 | $3.93 |