- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.04 / $10.65 / $87.61
| Facility | | $4.04 | $10.65 | $87.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $4.22 / $30.35
| Professional | | $3.16 | $4.22 | $30.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.07 / $3.07 / $3.07
| Professional | | $3.07 | $3.07 | $3.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.64 / $9.86 / $17.27
| Facility | | $2.64 | $9.86 | $17.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $3.98 / $5.67
| Professional | | $2.73 | $3.98 | $5.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $7.68 / $13.82
| Facility | | $3.31 | $7.68 | $13.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $5.78 / $7.23
| Professional | | $3.16 | $5.78 | $7.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.48 / $4.29 / $100.00
| Facility | | $3.48 | $4.29 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.98 / $2.78 / $3.78
| Professional | | $1.98 | $2.78 | $3.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.98 / $2.78 / $3.15
| Professional | | $1.98 | $2.78 | $3.15 |