- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.31 / $37.39 / $112.66
| Facility | | $7.31 | $37.39 | $112.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.46 / $5.46 / $8.31
| Professional | | $4.46 | $5.46 | $8.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.10 / $4.19
| Professional | | $3.02 | $3.10 | $4.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.48 / $11.86 / $22.43
| Facility | | $7.48 | $11.86 | $22.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.03 / $6.64 / $10.41
| Professional | | $5.03 | $6.64 | $10.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.04 / $6.04 / $6.04
| Facility | | $6.04 | $6.04 | $6.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.93 / $12.93 / $37.17
| Facility | | $3.93 | $12.93 | $37.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.87 / $4.04 / $8.77
| Professional | | $2.87 | $4.04 | $8.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $5.05
| Facility | | $5.05 | $5.05 | $5.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $3.45 / $10.81
| Professional | | $2.11 | $3.45 | $10.81 |