- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.10 / $10.66 / $35.76
| Facility | | $6.10 | $10.66 | $35.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.84 / $6.10 / $10.59
| Professional | | $3.84 | $6.10 | $10.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.81 / $12.98 / $100.00
| Facility | | $6.81 | $12.98 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.60 / $5.72 / $12.33
| Professional | | $2.60 | $5.72 | $12.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.43 / $9.53 / $16.88
| Facility | | $3.43 | $9.53 | $16.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.46 / $7.43 / $9.74
| Professional | | $3.46 | $7.43 | $9.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.62 / $6.26 / $6.88
| Professional | | $4.62 | $6.26 | $6.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.49 / $6.81 / $14.33
| Facility | | $6.49 | $6.81 | $14.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.49 / $9.74 / $17.85
| Facility | | $6.49 | $9.74 | $17.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.84 / $5.84 / $5.84
| Professional | | $5.84 | $5.84 | $5.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.46 / $10.65 / $17.85
| Facility | | $7.46 | $10.65 | $17.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.87 / $6.49 / $17.07
| Professional | | $4.87 | $6.49 | $17.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.74 / $6.17 / $6.49
| Facility | | $3.74 | $6.17 | $6.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $6.49
| Professional | | $2.73 | $2.73 | $6.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.92 / $2.92 / $3.36
| Professional | | $2.92 | $2.92 | $3.36 |