- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.72 / $28.80 / $77.45
| Facility | | $2.72 | $28.80 | $77.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $3.22 / $4.17
| Professional | | $2.86 | $3.22 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.78 / $10.35 / $16.39
| Facility | | $3.78 | $10.35 | $16.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $2.14 / $2.94
| Professional | | $1.85 | $2.14 | $2.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.10 / $3.43 / $9.23
| Facility | | $2.10 | $3.43 | $9.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $3.28 / $5.16
| Professional | | $2.19 | $3.28 | $5.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.72 / $4.30 / $7.06
| Facility | | $2.72 | $4.30 | $7.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $4.65 / $12.00
| Professional | | $2.40 | $4.65 | $12.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.64 / $2.64 / $4.50
| Facility | | $2.64 | $2.64 | $4.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $2.93 / $3.58
| Professional | | $2.15 | $2.93 | $3.58 |