- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.03 / $17.82 / $23.67
| Facility | | $10.03 | $17.82 | $23.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.69 / $8.36 / $68.98
| Professional | | $5.69 | $8.36 | $68.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.78 / $10.73 / $13.41
| Facility | | $4.78 | $10.73 | $13.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.09 / $6.49 / $8.13
| Professional | | $5.09 | $6.49 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.97 / $12.55 / $38.82
| Facility | | $6.97 | $12.55 | $38.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.74 / $12.39 / $15.49
| Professional | | $7.74 | $12.39 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.14 / $10.73 / $11.27
| Professional | | $0.14 | $10.73 | $11.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $3.55 / $3.55
| Professional | | $3.55 | $3.55 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.10 / $16.10 / $16.10
| Facility | | $16.10 | $16.10 | $16.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.76 / $6.06 / $10.73
| Professional | | $3.76 | $6.06 | $10.73 |