- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.98 / $9.12 / $64.57
| Facility | | $3.98 | $9.12 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.55 / $10.72
| Professional | | $3.02 | $3.55 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.68 / $6.17 / $10.72
| Facility | | $4.68 | $6.17 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.95 / $2.40 / $6.17
| Professional | | $1.95 | $2.40 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $5.37 / $17.38
| Facility | | $2.57 | $5.37 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $4.90 / $5.62
| Professional | | $3.16 | $4.90 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $3.98 / $5.75
| Professional | | $1.86 | $3.98 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.13 / $13.49 / $21.38
| Facility | | $5.13 | $13.49 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $10.47
| Facility | | $10.47 | $10.47 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.88 / $6.92
| Professional | | $2.00 | $2.88 | $6.92 |