- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.22 / $16.04 / $51.24
| Facility | | $6.22 | $16.04 | $51.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.08 / $4.59 / $5.09
| Professional | | $4.08 | $4.59 | $5.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.06 / $3.06 / $3.06
| Professional | | $3.06 | $3.06 | $3.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.11 / $12.31 / $17.68
| Facility | | $11.11 | $12.31 | $17.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.79 / $8.14 / $8.14
| Professional | | $6.79 | $8.14 | $8.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.35 / $6.55 / $27.72
| Facility | | $3.35 | $6.55 | $27.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.19 / $7.23 / $14.00
| Professional | | $3.19 | $7.23 | $14.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.61 / $4.61 / $11.02
| Facility | | $4.61 | $4.61 | $11.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $3.76 / $10.40
| Professional | | $2.14 | $3.76 | $10.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $3.06 / $10.61
| Professional | | $2.14 | $3.06 | $10.61 |