- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.62 / $11.01 / $121.44
| Facility | | $4.62 | $11.01 | $121.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.80 / $5.00 / $9.98
| Professional | | $4.80 | $5.00 | $9.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.36 / $3.36 / $3.83
| Professional | | $3.36 | $3.36 | $3.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.63 / $74.70 / $108.21
| Facility | | $55.63 | $74.70 | $108.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.32 / $5.32 / $5.60
| Professional | | $5.32 | $5.32 | $5.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.64 / $3.92 / $8.99
| Facility | | $3.64 | $3.92 | $8.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $5.57 / $7.74
| Professional | | $2.45 | $5.57 | $7.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.99 / $4.99 / $100.00
| Facility | | $4.99 | $4.99 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $3.15 / $7.00
| Professional | | $2.35 | $3.15 | $7.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $3.08 / $3.64
| Professional | | $2.35 | $3.08 | $3.64 |