- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.74 / $10.50 / $25.83
| Facility | | $5.74 | $10.50 | $25.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $5.74 / $6.65
| Professional | | $2.18 | $5.74 | $6.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.53 / $6.30 / $21.00
| Facility | | $5.53 | $6.30 | $21.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.80 / $1.84 / $4.20
| Professional | | $1.80 | $1.84 | $4.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.00 / $8.52 / $9.44
| Facility | | $7.00 | $8.52 | $9.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $8.05 / $9.92
| Professional | | $7.00 | $8.05 | $9.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.34 / $7.00 / $15.93
| Facility | | $3.34 | $7.00 | $15.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.57 / $6.28 / $10.33
| Professional | | $1.57 | $6.28 | $10.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.00 / $7.00 / $7.00
| Facility | | $7.00 | $7.00 | $7.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $4.20 / $8.40
| Professional | | $2.15 | $4.20 | $8.40 |