- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.07 / $30.82 / $89.28
| Facility | | $5.07 | $30.82 | $89.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.65 / $3.83 / $4.73
| Professional | | $3.65 | $3.83 | $4.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.84 / $2.84 / $2.99
| Professional | | $2.84 | $2.84 | $2.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.97 / $4.63 / $12.14
| Facility | | $2.97 | $4.63 | $12.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.80 / $4.78 / $7.23
| Professional | | $2.80 | $4.78 | $7.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.28 / $24.45 / $39.40
| Facility | | $4.28 | $24.45 | $39.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.84 / $2.98 / $6.01
| Professional | | $2.84 | $2.98 | $6.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.49 / $3.12
| Professional | | $2.27 | $2.49 | $3.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $2.52 / $6.37
| Professional | | $1.86 | $2.52 | $6.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.84 / $2.84
| Professional | | $2.45 | $2.84 | $2.84 |