- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.63 / $46.77 / $354.81
| Facility | | $3.63 | $46.77 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.63 / $3.55
| Professional | | $2.00 | $2.63 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.51 / $1.51 / $3.02
| Professional | | $1.51 | $1.51 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.72 / $6.03 / $10.96
| Facility | | $3.72 | $6.03 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.51 / $3.31 / $20.42
| Professional | | $2.51 | $3.31 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $47.86 / $47.86
| Facility | | $39.81 | $47.86 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.95 / $6.92 / $17.78
| Facility | | $1.95 | $6.92 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $2.00 / $3.31
| Professional | | $1.58 | $2.00 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.74 / $3.02 / $288.40
| Facility | | $1.74 | $3.02 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.26 / $1.74 / $4.68
| Professional | | $1.26 | $1.74 | $4.68 |