- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.70 / $25.84 / $76.26
| Facility | | $5.70 | $25.84 | $76.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.91 / $4.11 / $5.21
| Professional | | $2.91 | $4.11 | $5.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.84 / $23.83 / $40.86
| Facility | | $6.84 | $23.83 | $40.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.33 / $3.11 / $3.57
| Professional | | $2.33 | $3.11 | $3.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.47 / $2.47 / $2.47
| Facility | | $2.47 | $2.47 | $2.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $4.54 / $6.41
| Professional | | $2.18 | $4.54 | $6.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $4.55 / $4.55
| Professional | | $2.09 | $4.55 | $4.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.07 / $4.55 / $6.73
| Facility | | $3.07 | $4.55 | $6.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.65 / $3.80 / $6.41
| Professional | | $3.65 | $3.80 | $6.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $2.02 / $2.27
| Professional | | $1.60 | $2.02 | $2.27 |