- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.86 / $13.75 / $81.59
| Facility | | $2.86 | $13.75 | $81.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.04 / $3.20 / $3.58
| Professional | | $3.04 | $3.20 | $3.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $2.15 / $2.49
| Professional | | $2.15 | $2.15 | $2.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.42 / $3.84 / $11.04
| Facility | | $2.42 | $3.84 | $11.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.31 / $4.13 / $5.68
| Professional | | $2.31 | $4.13 | $5.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.56 / $20.36 / $32.82
| Facility | | $3.56 | $20.36 | $32.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.77 / $4.96 / $5.89
| Professional | | $1.77 | $4.96 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.72 / $1.89 / $2.36
| Professional | | $1.72 | $1.89 | $2.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.25 / $2.15 / $3.58
| Facility | | $1.25 | $2.15 | $3.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.61 / $2.93 / $5.00
| Professional | | $1.61 | $2.93 | $5.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $2.15 / $2.15
| Professional | | $1.85 | $2.15 | $2.15 |