- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.38 / $9.83 / $10.28
| Facility | | $3.38 | $9.83 | $10.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $3.50 / $5.27
| Professional | | $2.62 | $3.50 | $5.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.00 / $15.20 / $52.76
| Facility | | $8.00 | $15.20 | $52.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.62 / $4.51 / $4.51
| Professional | | $3.62 | $4.51 | $4.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.07 / $3.07 / $3.71
| Professional | | $3.07 | $3.07 | $3.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.12 / $6.90 / $14.59
| Professional | | $5.12 | $6.90 | $14.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.83 / $7.83 / $7.83
| Professional | | $7.83 | $7.83 | $7.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $8.43 / $9.02
| Professional | | $2.86 | $8.43 | $9.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $3.00 / $5.32
| Professional | | $2.13 | $3.00 | $5.32 |