- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.48 / $4.30 / $41.17
| Facility | | $2.48 | $4.30 | $41.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.21 / $2.27 / $2.92
| Professional | | $2.21 | $2.27 | $2.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.54 / $2.67 / $11.72
| Facility | | $2.54 | $2.67 | $11.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.25 / $2.09 / $6.83
| Professional | | $1.25 | $2.09 | $6.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.51 / $5.32 / $14.59
| Facility | | $3.51 | $5.32 | $14.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.52 / $2.46 / $3.87
| Professional | | $1.52 | $2.46 | $3.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.29 / $4.08 / $100.00
| Facility | | $2.29 | $4.08 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.78 / $3.09
| Professional | | $1.07 | $1.78 | $3.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.52 / $3.29
| Professional | | $1.07 | $1.52 | $3.29 |