- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.72 / $161.68 / $3,698.02
| Facility | | $2.72 | $161.68 | $3,698.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.72 / $2.81 / $3.41
| Professional | | $2.72 | $2.81 | $3.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $2.57 / $2.73
| Facility | | $2.57 | $2.57 | $2.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $2.73
| Professional | | $2.73 | $2.73 | $2.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.72 / $3.84 / $10.02
| Facility | | $2.72 | $3.84 | $10.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.89 / $3.55
| Professional | | $2.73 | $2.89 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $4.71 / $5.93
| Professional | | $2.18 | $4.71 | $5.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.30 / $10.30 / $12.64
| Facility | | $10.30 | $10.30 | $12.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.27 / $3.27 / $3.41
| Professional | | $3.27 | $3.27 | $3.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $2.89
| Professional | | $2.73 | $2.73 | $2.89 |