- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $13.83 / $75.06
| Facility | | $2.81 | $13.83 | $75.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.33 / $14.17 / $16.87
| Professional | | $13.33 | $14.17 | $16.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.73 / $15.18 / $17.73
| Facility | | $1.73 | $15.18 | $17.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.11 / $8.33
| Professional | | $2.11 | $2.11 | $8.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.87 / $23.62 / $27.84
| Facility | | $16.87 | $23.62 | $27.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.05 / $21.93 / $33.74
| Professional | | $18.05 | $21.93 | $33.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.97 / $13.13 / $30.60
| Facility | | $10.97 | $13.13 | $30.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.59 / $19.41 / $106.51
| Professional | | $8.59 | $19.41 | $106.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.27 / $9.27 / $9.27
| Professional | | $9.27 | $9.27 | $9.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.70 / $10.11 / $21.00
| Professional | | $1.70 | $10.11 | $21.00 |