- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $12.02 / $549.54
| Facility | | $10.47 | $12.02 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $7.08 / $12.02
| Professional | | $6.03 | $7.08 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $19.05 / $32.36
| Facility | | $11.75 | $19.05 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.79 / $7.41 / $13.49
| Professional | | $4.79 | $7.41 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.76 / $8.51 / $61.66
| Facility | | $7.76 | $8.51 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $13.49 / $16.98
| Professional | | $8.13 | $13.49 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $12.02 / $17.38
| Professional | | $5.62 | $12.02 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $7.41 / $21.38
| Professional | | $6.03 | $7.41 | $21.38 |