- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.03 / $33.88 / $43.65
| Facility | | $6.03 | $33.88 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $5.01 / $6.03
| Professional | | $3.02 | $5.01 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $5.75 / $17.78
| Facility | | $5.50 | $5.75 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.09 / $7.41 / $9.77
| Professional | | $3.09 | $7.41 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.46 / $20.42 / $30.90
| Facility | | $6.46 | $20.42 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.37 / $5.50 / $5.89
| Professional | | $4.37 | $5.50 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $6.46 / $20.42
| Professional | | $4.57 | $6.46 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.37 / $5.75 / $9.77
| Professional | | $5.37 | $5.75 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $3.24 / $12.02
| Facility | | $3.24 | $3.24 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $2.95 / $6.92
| Professional | | $2.75 | $2.95 | $6.92 |