- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.23 / $57.27 / $103.50
| Facility | | $6.23 | $57.27 | $103.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.95 / $5.84 / $7.71
| Professional | | $4.95 | $5.84 | $7.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.35 / $4.01 / $4.65
| Professional | | $3.35 | $4.01 | $4.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.41 / $16.66 / $24.14
| Facility | | $12.41 | $16.66 | $24.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.37 / $6.37 / $6.84
| Professional | | $6.37 | $6.37 | $6.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.36 / $4.68 / $10.95
| Facility | | $4.36 | $4.68 | $10.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.03 / $6.63 / $9.81
| Professional | | $3.03 | $6.63 | $9.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.85 / $8.38 / $98.28
| Facility | | $5.85 | $8.38 | $98.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $3.86 / $9.36
| Professional | | $2.81 | $3.86 | $9.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $6.03 / $9.14
| Facility | | $3.31 | $6.03 | $9.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $3.12 / $5.76
| Professional | | $2.81 | $3.12 | $5.76 |