- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.74 / $8.97 / $32.40
| Facility | | $3.74 | $8.97 | $32.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.16 / $2.27 / $16.32
| Professional | | $2.16 | $2.27 | $16.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.27 / $1.27 / $1.65
| Professional | | $1.27 | $1.27 | $1.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.42 / $5.29 / $9.26
| Facility | | $1.42 | $5.29 | $9.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.47 / $2.14 / $3.04
| Professional | | $1.47 | $2.14 | $3.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.77 / $4.13 / $7.43
| Facility | | $1.77 | $4.13 | $7.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.66 / $2.89 / $3.61
| Professional | | $1.66 | $2.89 | $3.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.91 / $2.29 / $100.00
| Facility | | $1.91 | $2.29 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.49 / $2.34
| Professional | | $1.07 | $1.49 | $2.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.49 / $2.08
| Professional | | $1.07 | $1.49 | $2.08 |