- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.96 / $13.69 / $40.79
| Facility | | $3.96 | $13.69 | $40.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.20 / $3.64 / $25.66
| Professional | | $3.20 | $3.64 | $25.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $2.78 / $3.07
| Professional | | $2.59 | $2.78 | $3.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.23 / $8.33 / $14.60
| Facility | | $2.23 | $8.33 | $14.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.31 / $3.36 / $4.79
| Professional | | $2.31 | $3.36 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $6.48 / $11.66
| Facility | | $2.81 | $6.48 | $11.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $4.96 / $6.20
| Professional | | $2.66 | $4.96 | $6.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.19 / $3.63 / $100.00
| Facility | | $3.19 | $3.63 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.68 / $2.35 / $5.50
| Professional | | $1.68 | $2.35 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.68 / $2.35 / $3.69
| Professional | | $1.68 | $2.35 | $3.69 |