- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.80 / $32.36 / $61.75
| Facility | | $5.80 | $32.36 | $61.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.27 / $4.28 / $25.72
| Professional | | $3.27 | $4.28 | $25.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.50 / $10.53 / $13.18
| Facility | | $6.50 | $10.53 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $4.54 / $7.05
| Professional | | $2.66 | $4.54 | $7.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $9.47 / $10.21
| Professional | | $4.00 | $9.47 | $10.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.32 / $4.61 / $12.45
| Facility | | $3.32 | $4.61 | $12.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $4.59 / $6.04
| Professional | | $4.00 | $4.59 | $6.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.00 / $4.98 / $11.28
| Facility | | $4.00 | $4.98 | $11.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.32 / $4.84 / $11.60
| Facility | | $3.32 | $4.84 | $11.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $4.80 / $6.00
| Professional | | $4.00 | $4.80 | $6.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.80 / $12.17 / $16.53
| Facility | | $7.80 | $12.17 | $16.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $4.67 / $9.85
| Professional | | $3.47 | $4.67 | $9.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.68 / $2.10 / $4.80
| Professional | | $1.68 | $2.10 | $4.80 |