- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.01 / $39.82 / $132.72
| Facility | | $3.01 | $39.82 | $132.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.07 / $3.21 / $3.67
| Professional | | $3.07 | $3.21 | $3.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.84 / $1.84 / $4.59
| Professional | | $1.84 | $1.84 | $4.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $3.30 / $3.86
| Facility | | $2.27 | $3.30 | $3.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.73 / $1.81 / $3.63
| Professional | | $1.73 | $1.81 | $3.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.67 / $4.40 / $5.14
| Facility | | $3.67 | $4.40 | $5.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.67 / $4.40 / $7.34
| Professional | | $3.67 | $4.40 | $7.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.39 / $2.81 / $6.65
| Facility | | $2.39 | $2.81 | $6.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.82 / $4.13 / $23.86
| Professional | | $1.82 | $4.13 | $23.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.02 / $2.02 / $2.02
| Professional | | $2.02 | $2.02 | $2.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.54 / $3.07 / $5.12
| Professional | | $1.54 | $3.07 | $5.12 |