- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.75 / $15.53 / $20.62
| Facility | | $8.75 | $15.53 | $20.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.01 / $7.94 / $60.12
| Professional | | $7.01 | $7.94 | $60.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.16 / $9.35 / $11.69
| Facility | | $4.16 | $9.35 | $11.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.74 / $5.65 / $6.86
| Professional | | $3.74 | $5.65 | $6.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.08 / $10.94 / $33.86
| Facility | | $6.08 | $10.94 | $33.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.22 / $10.74 / $13.42
| Professional | | $5.22 | $10.74 | $13.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.15 / $9.35 / $9.82
| Professional | | $0.15 | $9.35 | $9.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.36 / $2.36 / $2.36
| Professional | | $2.36 | $2.36 | $2.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.03 / $14.03 / $14.03
| Facility | | $14.03 | $14.03 | $14.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.93 / $4.04 / $9.61
| Professional | | $3.93 | $4.04 | $9.61 |