- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.49 / $11.84 / $33.13
| Facility | | $5.49 | $11.84 | $33.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.62 / $4.23 / $4.30
| Professional | | $3.62 | $4.23 | $4.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.37 / $26.57 / $51.82
| Facility | | $20.37 | $26.57 | $51.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.16 / $8.33 / $9.00
| Professional | | $4.16 | $8.33 | $9.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.81 / $7.74 / $12.24
| Professional | | $5.81 | $7.74 | $12.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.29 / $8.76 / $100.00
| Facility | | $3.29 | $8.76 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $3.29 / $11.00
| Professional | | $2.47 | $3.29 | $11.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.81 / $7.69 / $16.20
| Facility | | $5.81 | $7.69 | $16.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.38 / $10.00 / $14.33
| Professional | | $6.38 | $10.00 | $14.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $3.29 / $10.98
| Professional | | $2.47 | $3.29 | $10.98 |