- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.79 / $10.13 / $53.14
| Facility | | $3.79 | $10.13 | $53.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.53 / $3.72 / $4.00
| Professional | | $3.53 | $3.72 | $4.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.30 / $4.30 / $4.30
| Professional | | $4.30 | $4.30 | $4.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.92 / $4.63 / $11.07
| Facility | | $2.92 | $4.63 | $11.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.80 / $4.78 / $6.71
| Professional | | $2.80 | $4.78 | $6.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.28 / $24.45 / $39.40
| Facility | | $4.28 | $24.45 | $39.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $2.98 / $6.01
| Professional | | $2.59 | $2.98 | $6.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.27 / $2.84
| Professional | | $2.06 | $2.27 | $2.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.30 / $4.30 / $6.46
| Facility | | $4.30 | $4.30 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.72 / $2.56 / $6.01
| Professional | | $1.72 | $2.56 | $6.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.23 / $2.59 / $2.59
| Professional | | $2.23 | $2.59 | $2.59 |