- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $19.05 / $72.44
| Facility | | $10.00 | $19.05 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $8.91 / $13.49
| Professional | | $3.98 | $8.91 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.27 / $6.46 / $50.12
| Facility | | $4.27 | $6.46 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $6.92 / $22.39
| Professional | | $3.47 | $6.92 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.37 / $25.12 / $46.77
| Facility | | $5.37 | $25.12 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.24 / $7.94 / $12.02
| Professional | | $7.24 | $7.94 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $6.46 / $7.08
| Professional | | $6.46 | $6.46 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $7.94 / $13.49
| Facility | | $3.31 | $7.94 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $4.68 / $9.77
| Professional | | $2.63 | $4.68 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $6.46 / $13.49
| Professional | | $6.46 | $6.46 | $13.49 |