- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.11 / $10.76 / $17.32
| Facility | | $5.11 | $10.76 | $17.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.48 / $4.04 / $4.63
| Professional | | $3.48 | $4.04 | $4.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.78 / $2.78 / $3.22
| Professional | | $2.78 | $2.78 | $3.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.53 / $18.54 / $27.47
| Facility | | $16.53 | $18.54 | $27.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.01 / $9.01 / $11.64
| Professional | | $9.01 | $9.01 | $11.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.05 / $5.97 / $26.27
| Facility | | $3.05 | $5.97 | $26.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.89 / $6.56 / $21.00
| Professional | | $2.89 | $6.56 | $21.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.05 / $4.05 / $10.03
| Facility | | $4.05 | $4.05 | $10.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.95 / $3.79 / $9.47
| Professional | | $1.95 | $3.79 | $9.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.95 / $2.78 / $9.65
| Professional | | $1.95 | $2.78 | $9.65 |