- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.41 / $8.32 / $36.31
| Facility | | $7.41 | $8.32 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $5.01 / $12.88
| Professional | | $3.02 | $5.01 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.45 / $2.95
| Professional | | $2.45 | $2.45 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.75 / $12.88 / $26.92
| Facility | | $5.75 | $12.88 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.88 / $3.09 / $7.94
| Professional | | $2.88 | $3.09 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $2.75 / $3.47
| Professional | | $2.34 | $2.75 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $8,709.64 / $23,988.33
| Facility | | $134.90 | $8,709.64 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $4.07 / $5.13
| Professional | | $3.47 | $4.07 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.75 / $5.89 / $12.02
| Facility | | $2.75 | $5.89 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $3.80 / $6.03
| Professional | | $2.63 | $3.80 | $6.03 |