- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.74 / $29.81 / $132.61
| Facility | | $7.74 | $29.81 | $132.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $3.25 / $8.06
| Professional | | $2.86 | $3.25 | $8.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.76 / $9.07 / $28.28
| Facility | | $5.76 | $9.07 | $28.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.60 / $9.55 / $16.53
| Professional | | $5.60 | $9.55 | $16.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.48 / $19.36 / $31.20
| Facility | | $3.48 | $19.36 | $31.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $6.60 / $10.84
| Professional | | $4.84 | $6.60 | $10.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.58 / $2.83 / $3.54
| Professional | | $2.58 | $2.83 | $3.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.00 / $11.00 / $16.50
| Facility | | $11.00 | $11.00 | $16.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $4.62 / $11.33
| Professional | | $2.00 | $4.62 | $11.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.22 / $3.22 / $5.70
| Professional | | $3.22 | $3.22 | $5.70 |