- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.36 / $20.17 / $57.10
| Facility | | $3.36 | $20.17 | $57.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.14 / $4.24 / $8.60
| Professional | | $3.14 | $4.24 | $8.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.09 / $36.65 / $71.47
| Facility | | $28.09 | $36.65 | $71.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.60 / $7.21 / $7.79
| Professional | | $3.60 | $7.21 | $7.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.70 / $7.23 / $11.42
| Professional | | $5.70 | $7.23 | $11.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.85 / $9.49 / $100.00
| Facility | | $2.85 | $9.49 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.85 / $2.85 / $11.00
| Professional | | $2.85 | $2.85 | $11.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.81 / $9.67 / $14.89
| Facility | | $5.81 | $9.67 | $14.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.70 / $10.41 / $13.67
| Professional | | $5.70 | $10.41 | $13.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.71 / $2.85 / $9.50
| Professional | | $2.71 | $2.85 | $9.50 |