- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.32 / $15.80 / $43.89
| Facility | | $3.32 | $15.80 | $43.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $3.10 / $30.16
| Professional | | $3.10 | $3.10 | $30.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.58 / $32.07 / $62.54
| Facility | | $24.58 | $32.07 | $62.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.56 / $7.12 / $7.69
| Professional | | $3.56 | $7.12 | $7.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.27 / $6.71 / $10.61
| Professional | | $5.27 | $6.71 | $10.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $8.44 / $100.00
| Facility | | $2.81 | $8.44 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $2.81 / $10.00
| Professional | | $2.13 | $2.81 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.27 / $8.47 / $13.69
| Facility | | $5.27 | $8.47 | $13.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.63 / $9.58 / $12.24
| Professional | | $5.63 | $9.58 | $12.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.81 / $9.38
| Professional | | $2.11 | $2.81 | $9.38 |