- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.72 / $28.58 / $81.06
| Facility | | $7.72 | $28.58 | $81.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.32 / $6.19 / $42.76
| Professional | | $5.32 | $6.19 | $42.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.43 / $4.73 / $4.73
| Professional | | $4.43 | $4.73 | $4.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.82 / $14.25 / $24.97
| Facility | | $3.82 | $14.25 | $24.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.95 / $5.74 / $8.19
| Professional | | $3.95 | $5.74 | $8.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.75 / $11.08 / $19.94
| Facility | | $4.75 | $11.08 | $19.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.66 / $8.26 / $10.33
| Professional | | $4.66 | $8.26 | $10.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.12 / $6.18 / $100.00
| Facility | | $5.12 | $6.18 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $4.00 / $5.57
| Professional | | $2.86 | $4.00 | $5.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $4.00 / $5.25
| Professional | | $2.86 | $4.00 | $5.25 |