- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.75 / $9.77 / $18.62
| Facility | | $2.75 | $9.77 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.02 / $8.71
| Professional | | $3.02 | $3.02 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $2.45 / $3.98
| Professional | | $1.07 | $2.45 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $12.30 / $22.39
| Facility | | $5.89 | $12.30 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $4.07 / $5.62
| Professional | | $3.02 | $4.07 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $10.00 / $33.11
| Facility | | $2.57 | $10.00 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.74 / $2.45 / $5.62
| Professional | | $1.74 | $2.45 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.09 / $4.57 / $10.47
| Facility | | $3.09 | $4.57 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.55 / $3.98 / $4.79
| Facility | | $3.55 | $3.98 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.66 / $2.69 / $5.50
| Professional | | $1.66 | $2.69 | $5.50 |