- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.61 / $39.78 / $84.62
| Facility | | $4.61 | $39.78 | $84.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.14 / $4.00
| Professional | | $2.04 | $2.14 | $4.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $1.42 / $1.58
| Professional | | $1.42 | $1.42 | $1.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.60 / $2.52 / $7.02
| Facility | | $1.60 | $2.52 | $7.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.65 / $2.60 / $3.61
| Professional | | $1.65 | $2.60 | $3.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.35 / $13.43 / $21.64
| Facility | | $2.35 | $13.43 | $21.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.17 / $3.28 / $3.90
| Professional | | $1.17 | $3.28 | $3.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.13 / $1.25 / $1.56
| Professional | | $1.13 | $1.25 | $1.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.94 / $3.33
| Professional | | $1.07 | $1.94 | $3.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.23 / $1.42 / $1.42
| Professional | | $1.23 | $1.42 | $1.42 |