- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.09 / $70.43 / $889.52
| Facility | | $9.09 | $70.43 | $889.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.30 / $8.57 / $10.91
| Professional | | $3.30 | $8.57 | $10.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $4.25 / $18.00
| Facility | | $2.50 | $4.25 | $18.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $3.74 / $5.29
| Professional | | $2.40 | $3.74 | $5.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.40 / $3.00 / $13.80
| Facility | | $1.40 | $3.00 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.50 / $3.40 / $5.74
| Professional | | $1.50 | $3.40 | $5.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.49 / $5.00 / $6.32
| Professional | | $2.49 | $5.00 | $6.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.85 / $10.00 / $20.65
| Facility | | $2.85 | $10.00 | $20.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.80 / $3.00 / $15.91
| Professional | | $1.80 | $3.00 | $15.91 |