- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.73 / $8.38 / $22.46
| Facility | | $7.73 | $8.38 | $22.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.44 / $7.79 / $7.79
| Professional | | $7.44 | $7.79 | $7.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.47 / $16.51 / $29.58
| Facility | | $16.47 | $16.51 | $29.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.38 / $5.28 / $6.33
| Professional | | $4.38 | $5.28 | $6.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.97 / $9.11 / $25.80
| Facility | | $5.97 | $9.11 | $25.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.49 / $6.38 / $13.94
| Professional | | $5.49 | $6.38 | $13.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.84 / $10.54 / $16.84
| Facility | | $5.84 | $10.54 | $16.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.26 / $11.83 / $16.00
| Professional | | $10.26 | $11.83 | $16.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.87 / $6.02 / $11.74
| Professional | | $4.87 | $6.02 | $11.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $70.00 / $100.00
| Facility | | $50.00 | $70.00 | $100.00 |