- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.15 / $23.47 / $34.40
| Facility | | $4.15 | $23.47 | $34.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $3.87 / $37.68
| Professional | | $3.10 | $3.87 | $37.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.96 / $24.74 / $48.24
| Facility | | $18.96 | $24.74 | $48.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.45 / $8.91 / $9.60
| Professional | | $4.45 | $8.91 | $9.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $8.26 / $13.06
| Professional | | $6.61 | $8.26 | $13.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.52 / $9.09 / $100.00
| Facility | | $3.52 | $9.09 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $3.52 / $11.76
| Professional | | $2.64 | $3.52 | $11.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.03 / $8.55 / $18.37
| Facility | | $7.03 | $8.55 | $18.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.03 / $11.94 / $16.88
| Professional | | $7.03 | $11.94 | $16.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.60 / $3.52 / $6.45
| Professional | | $2.60 | $3.52 | $6.45 |