- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.37 / $32.82 / $64.48
| Facility | | $14.37 | $32.82 | $64.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.87 / $2.13 / $2.70
| Professional | | $1.87 | $2.13 | $2.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.02 / $2.08 / $6.53
| Facility | | $2.02 | $2.08 | $6.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.56 / $2.48 / $3.10
| Professional | | $1.56 | $2.48 | $3.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.23 / $4.09 / $4.09
| Professional | | $3.23 | $4.09 | $4.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.37 / $2.73 / $10.65
| Facility | | $2.37 | $2.73 | $10.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.82 / $1.90 / $2.79
| Professional | | $1.82 | $1.90 | $2.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $2.00 / $2.37
| Professional | | $1.42 | $2.00 | $2.37 |