- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.04 / $12.60 / $142.33
| Facility | | $4.04 | $12.60 | $142.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.95 / $3.28 / $4.28
| Professional | | $1.95 | $3.28 | $4.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.40 / $2.54 / $2.54
| Professional | | $1.40 | $2.54 | $2.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.47 / $6.79 / $10.74
| Facility | | $5.47 | $6.79 | $10.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.87 / $4.88 / $5.66
| Professional | | $4.87 | $4.88 | $5.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.41 / $4.70 / $20.42
| Facility | | $2.41 | $4.70 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $5.16 / $11.00
| Professional | | $2.27 | $5.16 | $11.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.32 / $3.32 / $9.94
| Facility | | $3.32 | $3.32 | $9.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.84 / $2.20 / $6.86
| Professional | | $1.84 | $2.20 | $6.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.84 / $2.20 / $5.87
| Professional | | $1.84 | $2.20 | $5.87 |