- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.89 / $18.62 / $81.28
| Facility | | $3.89 | $18.62 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $4.68 / $18.62
| Professional | | $3.02 | $4.68 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $3.09 / $8.13
| Professional | | $2.57 | $3.09 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $7.08 / $7.08
| Professional | | $3.72 | $7.08 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.39 / $12.59 / $20.42
| Facility | | $3.39 | $12.59 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $3.98 / $7.76
| Professional | | $2.40 | $3.98 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $100.00
| Facility | | $60.26 | $60.26 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.68 / $4.68 / $11.75
| Professional | | $4.68 | $4.68 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.86 / $4.37 / $5.13
| Facility | | $1.86 | $4.37 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $3.39 / $5.75
| Professional | | $2.19 | $3.39 | $5.75 |