- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $30.71 / $203.52
| Facility | | $5.50 | $30.71 | $203.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.04 / $4.26 / $5.08
| Professional | | $4.04 | $4.26 | $5.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.05 / $3.05 / $3.05
| Professional | | $3.05 | $3.05 | $3.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.25 / $5.08 / $6.35
| Facility | | $2.25 | $5.08 | $6.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $3.07 / $3.74
| Professional | | $2.34 | $3.07 | $3.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.30 / $5.94 / $18.38
| Facility | | $3.30 | $5.94 | $18.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.60 / $5.78 / $7.23
| Professional | | $3.60 | $5.78 | $7.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.06 / $5.08 / $5.33
| Professional | | $0.06 | $5.08 | $5.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.63 / $1.63 / $1.63
| Professional | | $1.63 | $1.63 | $1.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $2.79 / $5.08
| Professional | | $2.13 | $2.79 | $5.08 |