- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.75 / $10.15 / $36.77
| Facility | | $5.75 | $10.15 | $36.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $4.32 / $5.37
| Professional | | $3.50 | $4.32 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.86 / $13.29 / $21.07
| Facility | | $4.86 | $13.29 | $21.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $1.93 / $3.53
| Professional | | $1.93 | $1.93 | $3.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.69 / $4.40 / $11.84
| Facility | | $2.69 | $4.40 | $11.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $3.25 / $6.71
| Professional | | $2.54 | $3.25 | $6.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.50 / $4.86 / $8.17
| Facility | | $3.50 | $4.86 | $8.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.08 / $5.98 / $8.51
| Professional | | $3.08 | $5.98 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.40 / $3.40 / $5.78
| Facility | | $3.40 | $3.40 | $5.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $2.70 / $4.59
| Professional | | $1.93 | $2.70 | $4.59 |