- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.75 / $93.48 / $98.04
| Facility | | $29.75 | $93.48 | $98.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.62 / $6.04 / $7.13
| Professional | | $4.62 | $6.04 | $7.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $34.33 / $55.75
| Facility | | $9.33 | $34.33 | $55.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.18 / $4.24 / $4.87
| Professional | | $3.18 | $4.24 | $4.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.37 / $3.37 / $3.37
| Facility | | $3.37 | $3.37 | $3.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.27 / $5.78 / $9.86
| Professional | | $3.27 | $5.78 | $9.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.85 / $2.85 / $2.85
| Professional | | $2.85 | $2.85 | $2.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.61 / $6.22 / $10.11
| Facility | | $4.61 | $6.22 | $10.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.18 / $5.18 / $9.86
| Professional | | $5.18 | $5.18 | $9.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $3.08 / $3.17
| Professional | | $2.18 | $3.08 | $3.17 |