- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.18 / $26.78 / $87.50
| Facility | | $4.18 | $26.78 | $87.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.88 / $4.51 / $16.62
| Professional | | $2.88 | $4.51 | $16.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.65 / $9.15 / $10.10
| Facility | | $5.65 | $9.15 | $10.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $3.79 / $6.46
| Professional | | $1.78 | $3.79 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.48 / $8.68 / $9.35
| Professional | | $3.48 | $8.68 | $9.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $3.93 / $12.14
| Facility | | $2.50 | $3.93 | $12.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.48 / $4.00 / $5.01
| Professional | | $3.48 | $4.00 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.48 / $3.83 / $7.68
| Facility | | $3.48 | $3.83 | $7.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.54 / $4.18 / $9.19
| Facility | | $2.54 | $4.18 | $9.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.31 / $3.83 / $4.87
| Professional | | $3.31 | $3.83 | $4.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.79 / $10.59 / $14.38
| Facility | | $6.79 | $10.59 | $14.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $3.26 / $8.21
| Professional | | $2.61 | $3.26 | $8.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $2.09 / $3.57
| Professional | | $2.09 | $2.09 | $3.57 |