- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.37 / $23.93 / $54.92
| Facility | | $2.37 | $23.93 | $54.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.92 / $2.75 / $3.55
| Professional | | $1.92 | $2.75 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.29 / $3.16 / $23.97
| Facility | | $2.29 | $3.16 | $23.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $1.42 / $2.74
| Professional | | $1.42 | $1.42 | $2.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.86 / $3.36 / $5.05
| Facility | | $2.86 | $3.36 | $5.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.29 / $3.10 / $3.50
| Professional | | $2.29 | $3.10 | $3.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.37 / $2.87
| Professional | | $2.37 | $2.37 | $2.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.37 / $20.88 / $62.65
| Facility | | $2.37 | $20.88 | $62.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.91 / $2.72 / $3.88
| Professional | | $1.91 | $2.72 | $3.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.23 / $4.68
| Professional | | $2.00 | $3.23 | $4.68 |