- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.63 / $10.56 / $36.49
| Facility | | $3.63 | $10.56 | $36.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.64 / $3.97 / $7.64
| Professional | | $3.64 | $3.97 | $7.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $2.64 / $2.64
| Professional | | $2.64 | $2.64 | $2.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.74 / $27.85 / $40.33
| Facility | | $20.74 | $27.85 | $40.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.18 / $4.18 / $4.40
| Professional | | $4.18 | $4.18 | $4.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.86 / $3.07 / $7.19
| Facility | | $2.86 | $3.07 | $7.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.02 / $4.51 / $6.71
| Professional | | $2.02 | $4.51 | $6.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.00 / $4.00 / $100.00
| Facility | | $4.00 | $4.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $2.54 / $5.50
| Professional | | $1.85 | $2.54 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.58 / $4.40 / $19.03
| Facility | | $1.58 | $4.40 | $19.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $2.42 / $2.86
| Professional | | $1.85 | $2.42 | $2.86 |