- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.93 / $39.44 / $152.83
| Facility | | $5.93 | $39.44 | $152.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.25 / $4.63 / $5.16
| Professional | | $4.25 | $4.63 | $5.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.58 / $3.10 / $3.47
| Professional | | $2.58 | $3.10 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.49 / $5.54 / $15.05
| Facility | | $3.49 | $5.54 | $15.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.46 / $5.78 / $7.75
| Professional | | $3.46 | $5.78 | $7.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.13 / $29.30 / $47.22
| Facility | | $5.13 | $29.30 | $47.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $7.13 / $8.48
| Professional | | $2.54 | $7.13 | $8.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $2.72 / $3.41
| Professional | | $2.48 | $2.72 | $3.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.63 / $3.10 / $4.63
| Facility | | $2.63 | $3.10 | $4.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $3.02 / $7.20
| Professional | | $2.06 | $3.02 | $7.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.67 / $3.10 / $3.10
| Professional | | $2.67 | $3.10 | $3.10 |