- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.77 / $9.05 / $50.65
| Facility | | $3.77 | $9.05 | $50.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.16 / $2.52 / $8.88
| Professional | | $2.16 | $2.52 | $8.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $5.88 / $7.34
| Professional | | $3.72 | $5.88 | $7.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.28 / $5.74 / $23.43
| Professional | | $3.28 | $5.74 | $23.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.28 / $4.26 / $12.09
| Facility | | $3.28 | $4.26 | $12.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.97 / $3.28 / $7.54
| Professional | | $1.97 | $3.28 | $7.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.08 / $6.00 / $8.72
| Facility | | $3.08 | $6.00 | $8.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $6.00 / $8.56
| Professional | | $3.80 | $6.00 | $8.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.97 / $1.97 / $7.02
| Professional | | $1.97 | $1.97 | $7.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $3.28 / $3.28
| Professional | | $2.59 | $3.28 | $3.28 |