- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.83 / $31.80 / $98.47
| Facility | | $10.83 | $31.80 | $98.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.67 / $5.75 / $6.61
| Professional | | $5.67 | $5.75 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.79 / $8.13 / $13.41
| Facility | | $7.79 | $8.13 | $13.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $4.96 / $12.59
| Professional | | $3.47 | $4.96 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.25 / $15.79 / $27.77
| Facility | | $6.25 | $15.79 | $27.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.83 / $7.30 / $9.28
| Professional | | $4.83 | $7.30 | $9.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.78 / $5.54 / $11.21
| Professional | | $2.78 | $5.54 | $11.21 |