- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.43 / $13.55 / $90.78
| Facility | | $3.43 | $13.55 | $90.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $3.29 / $3.67
| Professional | | $2.39 | $3.29 | $3.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $2.54 / $2.54
| Professional | | $2.54 | $2.54 | $2.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.90 / $3.67 / $11.01
| Facility | | $2.90 | $3.67 | $11.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.73 / $2.27 / $4.00
| Professional | | $1.73 | $2.27 | $4.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.67 / $4.04 / $5.14
| Facility | | $3.67 | $4.04 | $5.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $3.85 / $4.95
| Professional | | $2.39 | $3.85 | $4.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.68 / $3.67 / $9.23
| Facility | | $2.68 | $3.67 | $9.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $4.13 / $8.19
| Professional | | $2.41 | $4.13 | $8.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.54 / $2.36 / $3.67
| Professional | | $1.54 | $2.36 | $3.67 |