- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.22 / $48.80 / $94.34
| Facility | | $6.22 | $48.80 | $94.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.40 / $4.65 / $13.74
| Professional | | $4.40 | $4.65 | $13.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.18 / $5.44 / $23.91
| Facility | | $5.18 | $5.44 | $23.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $4.40 / $13.93
| Professional | | $2.56 | $4.40 | $13.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.70 / $10.87 / $29.19
| Facility | | $6.70 | $10.87 | $29.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.04 / $5.27 / $7.74
| Professional | | $3.04 | $5.27 | $7.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.66 / $9.11 / $60.00
| Facility | | $4.66 | $9.11 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.85 / $5.18 / $7.78
| Professional | | $2.85 | $5.18 | $7.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.39 / $7.23 / $7.77
| Facility | | $6.39 | $7.23 | $7.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $5.18 / $8.77
| Professional | | $2.59 | $5.18 | $8.77 |