- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.09 / $13.54 / $294.82
| Facility | | $4.09 | $13.54 | $294.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.33 / $2.69 / $3.56
| Professional | | $2.33 | $2.69 | $3.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.50 / $2.08 / $2.27
| Professional | | $1.50 | $2.08 | $2.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.90 / $6.14 / $11.81
| Facility | | $1.90 | $6.14 | $11.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.96 / $2.86 / $4.07
| Professional | | $1.96 | $2.86 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.09 / $4.84 / $8.73
| Facility | | $2.09 | $4.84 | $8.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.72 / $4.65
| Professional | | $2.00 | $3.72 | $4.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.40 / $2.71 / $60.00
| Facility | | $2.40 | $2.71 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.26 / $1.75 / $2.75
| Professional | | $1.26 | $1.75 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.26 / $1.75 / $1.83
| Professional | | $1.26 | $1.75 | $1.83 |