- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.64 / $16.79 / $90.38
| Facility | | $3.64 | $16.79 | $90.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.68 / $3.29 / $25.72
| Professional | | $2.68 | $3.29 | $25.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.60 / $2.60 / $2.60
| Professional | | $2.60 | $2.60 | $2.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.24 / $7.99 / $14.63
| Facility | | $2.24 | $7.99 | $14.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.31 / $3.37 / $4.80
| Professional | | $2.31 | $3.37 | $4.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.63 / $6.50 / $11.70
| Facility | | $2.63 | $6.50 | $11.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.50 / $4.54 / $6.20
| Professional | | $2.50 | $4.54 | $6.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.05 / $3.32 / $80.00
| Facility | | $3.05 | $3.32 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.68 / $2.15 / $3.20
| Professional | | $1.68 | $2.15 | $3.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.68 / $2.15 / $3.38
| Professional | | $1.68 | $2.15 | $3.38 |