- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $39.82 / $90.53
| Facility | | $5.25 | $39.82 | $90.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.07 / $3.21 / $4.40
| Professional | | $3.07 | $3.21 | $4.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.67 / $4.69 / $12.70
| Facility | | $3.67 | $4.69 | $12.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.81 / $1.81 / $4.24
| Professional | | $1.81 | $1.81 | $4.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $6.15 / $12.54
| Facility | | $2.57 | $6.15 | $12.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $4.13 / $5.33
| Professional | | $2.34 | $4.13 | $5.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.75 / $3.67 / $4.61
| Facility | | $2.75 | $3.67 | $4.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.54 / $2.20 / $5.12
| Professional | | $1.54 | $2.20 | $5.12 |