- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.85 / $19.41 / $75.59
| Facility | | $7.85 | $19.41 | $75.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.33 / $6.43 / $8.60
| Professional | | $5.33 | $6.43 | $8.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.60 / $4.32 / $5.00
| Professional | | $3.60 | $4.32 | $5.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.36 / $7.92 / $12.74
| Facility | | $6.36 | $7.92 | $12.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.41 / $4.12 / $5.57
| Professional | | $3.41 | $4.12 | $5.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.54 / $4.54 / $4.54
| Facility | | $4.54 | $4.54 | $4.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.04 / $5.76 / $8.41
| Professional | | $5.04 | $5.76 | $8.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.40 / $7.56 / $9.72
| Facility | | $5.40 | $7.56 | $9.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.68 / $7.20 / $11.86
| Professional | | $4.68 | $7.20 | $11.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.68 / $7.41 / $16.23
| Facility | | $4.68 | $7.41 | $16.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.63 / $6.74 / $10.48
| Professional | | $3.63 | $6.74 | $10.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.43 / $24.24 / $58.01
| Facility | | $6.43 | $24.24 | $58.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.88 / $5.27 / $12.61
| Professional | | $2.88 | $5.27 | $12.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.40 / $5.94 / $8.64
| Professional | | $5.40 | $5.94 | $8.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $4.33 / $10.49
| Professional | | $3.02 | $4.33 | $10.49 |