- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.84 / $10.05 / $27.29
| Facility | | $2.84 | $10.05 | $27.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.65 / $2.65 / $25.78
| Professional | | $2.65 | $2.65 | $25.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.96 / $24.74 / $48.24
| Facility | | $18.96 | $24.74 | $48.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.04 / $6.09 / $6.58
| Professional | | $3.04 | $6.09 | $6.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.90 / $5.68 / $8.98
| Professional | | $2.90 | $5.68 | $8.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.41 / $4.75 / $70.00
| Facility | | $2.41 | $4.75 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $4.01 / $8.02
| Professional | | $2.41 | $4.01 | $8.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.90 / $5.61 / $10.27
| Facility | | $2.90 | $5.61 | $10.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.80 / $6.73 / $10.47
| Professional | | $4.80 | $6.73 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $4.01 / $8.02
| Professional | | $2.41 | $4.01 | $8.02 |