- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.47 / $25.58 / $136.11
| Facility | | $4.47 | $25.58 | $136.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.37 / $4.54 / $5.75
| Professional | | $4.37 | $4.54 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.58 / $5.18 / $6.04
| Facility | | $3.58 | $5.18 | $6.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.38 / $2.48 / $4.98
| Professional | | $2.38 | $2.48 | $4.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.75 / $6.90 / $8.18
| Facility | | $5.75 | $6.90 | $8.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $6.96 / $11.50
| Professional | | $5.75 | $6.96 | $11.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.74 / $4.47 / $9.11
| Facility | | $3.74 | $4.47 | $9.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $6.47 / $33.06
| Professional | | $2.64 | $6.47 | $33.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $3.16 / $3.16
| Professional | | $3.16 | $3.16 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.42 / $4.21 / $7.02
| Professional | | $2.42 | $4.21 | $7.02 |