- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.07 / $14.25 / $51.32
| Facility | | $4.07 | $14.25 | $51.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $4.13 / $7.12
| Professional | | $3.98 | $4.13 | $7.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.38 / $3.29 / $3.64
| Professional | | $2.38 | $3.29 | $3.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.66 / $10.09 / $17.38
| Facility | | $2.66 | $10.09 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $4.00 / $5.70
| Professional | | $2.75 | $4.00 | $5.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.32 / $7.73 / $13.91
| Facility | | $3.32 | $7.73 | $13.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $5.78 / $7.23
| Professional | | $2.86 | $5.78 | $7.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.56 / $4.13 / $100.00
| Facility | | $3.56 | $4.13 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.85 / $3.91 / $4.75
| Professional | | $2.85 | $3.91 | $4.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.85 / $3.91 / $4.75
| Professional | | $2.85 | $3.91 | $4.75 |