- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.80 / $47.86 / $91.20
| Facility | | $3.80 | $47.86 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.32 / $2.14 / $9.55
| Professional | | $1.32 | $2.14 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.20 / $1.62 / $2.34
| Professional | | $1.20 | $1.62 | $2.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.46 / $19.05 / $37.15
| Facility | | $6.46 | $19.05 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.98 / $9.33
| Professional | | $2.00 | $3.98 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.55 / $6.03 / $19.50
| Facility | | $1.55 | $6.03 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.10 / $1.55 / $3.09
| Professional | | $1.10 | $1.55 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.86 / $2.75 / $6.76
| Facility | | $1.86 | $2.75 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.14 / $2.34 / $2.82
| Facility | | $2.14 | $2.34 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $2.29 / $3.31
| Professional | | $1.41 | $2.29 | $3.31 |