- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.47 / $35.96 / $92.55
| Facility | | $6.47 | $35.96 | $92.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.44 / $3.58 / $4.11
| Professional | | $3.44 | $3.58 | $4.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.65 / $4.86 / $8.01
| Facility | | $4.65 | $4.86 | $8.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.96 / $7.53
| Professional | | $2.06 | $2.96 | $7.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.75 / $9.42 / $16.57
| Facility | | $3.75 | $9.42 | $16.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $4.36 / $5.68
| Professional | | $2.86 | $4.36 | $5.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.66 / $3.31 / $6.32
| Professional | | $1.66 | $3.31 | $6.32 |