- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.14 / $15.12 / $61.92
| Facility | | $7.14 | $15.12 | $61.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.68 / $4.28 / $9.32
| Professional | | $3.68 | $4.28 | $9.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.60 / $15.20 / $57.27
| Facility | | $6.60 | $15.20 | $57.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $3.88 / $5.04
| Professional | | $3.50 | $3.88 | $5.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.52 / $11.95 / $23.83
| Facility | | $3.52 | $11.95 | $23.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.56 / $5.78 / $7.75
| Professional | | $3.56 | $5.78 | $7.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.29 / $7.93 / $30.75
| Professional | | $5.29 | $7.93 | $30.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.55 / $6.55 / $6.55
| Professional | | $6.55 | $6.55 | $6.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $3.46 / $6.30
| Professional | | $2.52 | $3.46 | $6.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.83 / $10.08 / $10.08
| Facility | | $1.83 | $10.08 | $10.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $3.53 / $5.30
| Professional | | $2.59 | $3.53 | $5.30 |