- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.60 / $25.65 / $545.97
| Facility | | $6.60 | $25.65 | $545.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.72 / $4.84 / $6.40
| Professional | | $2.72 | $4.84 | $6.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.20 / $3.47 / $12.78
| Facility | | $3.20 | $3.47 | $12.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.37 / $3.72 / $4.65
| Professional | | $1.37 | $3.72 | $4.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.62 / $4.54 / $9.60
| Facility | | $2.62 | $4.54 | $9.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.28 / $3.28 / $3.94
| Professional | | $3.28 | $3.28 | $3.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.28 / $3.28 / $3.28
| Professional | | $3.28 | $3.28 | $3.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.92 / $6.86 / $11.81
| Facility | | $4.92 | $6.86 | $11.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.79 / $5.82 / $5.86
| Professional | | $2.79 | $5.82 | $5.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.97 / $1.99 / $3.85
| Professional | | $1.97 | $1.99 | $3.85 |