- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.63 / $36.38 / $61.41
| Facility | | $12.63 | $36.38 | $61.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.24 / $4.38 / $5.05
| Professional | | $4.24 | $4.38 | $5.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.65 / $10.19 / $11.45
| Professional | | $7.65 | $10.19 | $11.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $5.84 / $7.34
| Professional | | $5.78 | $5.84 | $7.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.59 / $22.58 / $63.48
| Facility | | $3.59 | $22.58 | $63.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $6.07 / $8.60
| Professional | | $2.41 | $6.07 | $8.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $3.40 / $8.34
| Professional | | $2.13 | $3.40 | $8.34 |