- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.42 / $81.15 / $235.43
| Facility | | $6.42 | $81.15 | $235.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $3.21 / $3.67
| Professional | | $2.86 | $3.21 | $3.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.88 / $10.61 / $16.80
| Facility | | $3.88 | $10.61 | $16.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.54 / $1.54 / $2.94
| Professional | | $1.54 | $1.54 | $2.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.15 / $3.51 / $9.46
| Facility | | $2.15 | $3.51 | $9.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $3.35 / $5.16
| Professional | | $2.24 | $3.35 | $5.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.79 / $4.40 / $7.22
| Facility | | $2.79 | $4.40 | $7.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.46 / $4.76 / $13.54
| Professional | | $2.46 | $4.76 | $13.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.67 / $3.67 / $4.61
| Facility | | $3.67 | $3.67 | $4.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.54 / $2.10 / $2.72
| Professional | | $1.54 | $2.10 | $2.72 |