- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.77 / $42.60 / $119.46
| Facility | | $11.77 | $42.60 | $119.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.40 / $3.53 / $5.34
| Professional | | $3.40 | $3.53 | $5.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.63 / $4.83 / $7.97
| Facility | | $4.63 | $4.83 | $7.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.95 / $7.46
| Professional | | $2.06 | $2.95 | $7.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.75 / $9.36 / $16.47
| Facility | | $3.75 | $9.36 | $16.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $4.34 / $5.68
| Professional | | $2.86 | $4.34 | $5.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $3.93 / $6.29
| Professional | | $2.27 | $3.93 | $6.29 |