- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.81 / $15.46 / $288.56
| Facility | | $6.81 | $15.46 | $288.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $3.53 / $6.05
| Professional | | $2.61 | $3.53 | $6.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.19 / $3.54 / $12.97
| Facility | | $2.19 | $3.54 | $12.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $4.26 / $7.23
| Professional | | $2.14 | $4.26 | $7.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.15 / $17.98 / $29.01
| Facility | | $3.15 | $17.98 | $29.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $3.02 / $5.22
| Professional | | $2.57 | $3.02 | $5.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.42 / $2.66 / $3.32
| Professional | | $2.42 | $2.66 | $3.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.61 / $3.02 / $4.54
| Facility | | $1.61 | $3.02 | $4.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.02 / $2.66 / $6.03
| Professional | | $2.02 | $2.66 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $3.02 / $3.02
| Professional | | $2.61 | $3.02 | $3.02 |