- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.77 / $16.60 / $43.30
| Facility | | $2.77 | $16.60 | $43.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $2.72 / $3.80
| Professional | | $2.61 | $2.72 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.85 / $10.52 / $16.67
| Facility | | $3.85 | $10.52 | $16.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.52 / $1.52 / $2.68
| Professional | | $1.52 | $1.52 | $2.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.13 / $3.20 / $9.39
| Facility | | $2.13 | $3.20 | $9.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.96 / $2.74 / $5.16
| Professional | | $1.96 | $2.74 | $5.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.77 / $3.96 / $5.91
| Facility | | $2.77 | $3.96 | $5.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.44 / $4.73 / $13.43
| Professional | | $2.44 | $4.73 | $13.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.77 / $3.77 / $3.77
| Facility | | $3.77 | $3.77 | $3.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.53 / $1.76 / $2.69
| Professional | | $1.53 | $1.76 | $2.69 |