- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $35.48 / $77.62
| Facility | | $9.77 | $35.48 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.24 / $19.05
| Professional | | $2.04 | $2.24 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $4.79 / $5.37
| Professional | | $3.47 | $4.79 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.45 / $3.16
| Professional | | $2.45 | $2.45 | $3.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.34 / $15.14 / $30.20
| Facility | | $2.34 | $15.14 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $2.57 / $4.07
| Professional | | $1.41 | $2.57 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $2.57 / $4.07
| Professional | | $1.41 | $2.57 | $4.07 |