- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.44 / $18.89 / $65.53
| Facility | | $4.44 | $18.89 | $65.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.12 / $3.28 / $4.44
| Professional | | $3.12 | $3.28 | $4.44 |
- 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
- $4.51 / $7.20 / $13.60
| Facility | | $4.51 | $7.20 | $13.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.05 / $4.04 / $6.32
| Professional | | $3.05 | $4.04 | $6.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.60 / $3.60 / $3.67
| Facility | | $3.60 | $3.60 | $3.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.39 / $8.36 / $22.62
| Facility | | $2.39 | $8.36 | $22.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.71 / $2.46 / $5.16
| Professional | | $1.71 | $2.46 | $5.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.32 / $3.07 / $3.67
| Facility | | $1.32 | $3.07 | $3.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.54 / $2.10 / $5.72
| Professional | | $1.54 | $2.10 | $5.72 |