- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.80 / $34.50 / $85.40
| Facility | | $4.80 | $34.50 | $85.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.36 / $4.01 / $5.53
| Professional | | $2.36 | $4.01 | $5.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.89 / $2.89 / $2.89
| Professional | | $2.89 | $2.89 | $2.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.47 / $6.15 / $16.64
| Facility | | $3.47 | $6.15 | $16.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $2.38 / $9.64
| Professional | | $1.78 | $2.38 | $9.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.13 / $4.80 / $7.70
| Facility | | $3.13 | $4.80 | $7.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.13 / $3.13 / $4.80
| Professional | | $3.13 | $3.13 | $4.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.84 / $10.58 / $14.71
| Facility | | $4.84 | $10.58 | $14.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.45 / $5.78 / $7.23
| Professional | | $3.45 | $5.78 | $7.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.26 / $6.25 / $17.28
| Professional | | $5.26 | $6.25 | $17.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $3.76 / $10.10
| Professional | | $2.10 | $3.76 | $10.10 |