- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.28 / $16.80 / $23.36
| Facility | | $5.28 | $16.80 | $23.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $2.72 / $3.99
| Professional | | $2.61 | $2.72 | $3.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.93 / $9.60 / $10.76
| Facility | | $5.93 | $9.60 | $10.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $3.79 / $6.46
| Professional | | $2.13 | $3.79 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.64 / $8.68 / $9.35
| Professional | | $3.64 | $8.68 | $9.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.65 / $3.77 / $9.96
| Facility | | $2.65 | $3.77 | $9.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.64 / $4.09 / $31.50
| Professional | | $3.64 | $4.09 | $31.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.64 / $4.19 / $19.77
| Facility | | $3.64 | $4.19 | $19.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.65 / $4.37 / $10.56
| Facility | | $2.65 | $4.37 | $10.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.64 / $4.00 / $5.09
| Professional | | $3.64 | $4.00 | $5.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.10 / $11.08 / $15.04
| Facility | | $7.10 | $11.08 | $15.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.07 / $3.83 / $9.02
| Professional | | $3.07 | $3.83 | $9.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.46 / $5.46 / $5.82
| Facility | | $5.46 | $5.46 | $5.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.53 / $1.71 / $4.37
| Professional | | $1.53 | $1.71 | $4.37 |