- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.33 / $18.14 / $81.63
| Facility | | $8.33 | $18.14 | $81.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.94 / $5.30 / $37.81
| Professional | | $3.94 | $5.30 | $37.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.94 / $2.94 / $3.82
| Professional | | $2.94 | $2.94 | $3.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.29 / $12.28 / $21.51
| Facility | | $3.29 | $12.28 | $21.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.40 / $4.95 / $7.06
| Professional | | $3.40 | $4.95 | $7.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.12 / $9.55 / $17.19
| Facility | | $4.12 | $9.55 | $17.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.82 / $6.61 / $8.77
| Professional | | $3.82 | $6.61 | $8.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.41 / $5.34 / $100.00
| Facility | | $4.41 | $5.34 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $3.45 / $4.80
| Professional | | $2.47 | $3.45 | $4.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $3.45 / $4.70
| Professional | | $2.47 | $3.45 | $4.70 |