- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.37 / $45.00 / $75.05
| Facility | | $2.37 | $45.00 | $75.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.23 / $11.77
| Professional | | $2.06 | $2.23 | $11.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.37 / $3.37 / $5.56
| Facility | | $2.37 | $3.37 | $5.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.90 / $2.37 / $2.37
| Professional | | $1.90 | $2.37 | $2.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.62 / $8.36 / $20.11
| Facility | | $4.62 | $8.36 | $20.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.50 / $3.15 / $4.40
| Professional | | $2.50 | $3.15 | $4.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.57 / $7.64 / $15.84
| Facility | | $4.57 | $7.64 | $15.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $2.48 / $3.92
| Professional | | $2.48 | $2.48 | $3.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.01 / $26.97 / $58.28
| Facility | | $5.01 | $26.97 | $58.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $2.65 / $24.42
| Professional | | $1.42 | $2.65 | $24.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $2.60 / $5.03
| Professional | | $1.42 | $2.60 | $5.03 |