- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.06 / $21.14 / $86.31
| Facility | | $6.06 | $21.14 | $86.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $3.56 / $7.00
| Professional | | $3.00 | $3.56 | $7.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $2.73 / $3.01
| Professional | | $2.15 | $2.73 | $3.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.40 / $7.71 / $14.96
| Facility | | $2.40 | $7.71 | $14.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.49 / $3.62 / $5.15
| Professional | | $2.49 | $3.62 | $5.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.97 / $6.98 / $12.56
| Facility | | $2.97 | $6.98 | $12.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.29 / $4.96 / $6.71
| Professional | | $2.29 | $4.96 | $6.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.43 / $4.09 / $100.00
| Facility | | $3.43 | $4.09 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $3.29 / $4.29
| Professional | | $2.57 | $3.29 | $4.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $3.29 / $4.29
| Professional | | $2.57 | $3.29 | $4.29 |