- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.36 / $35.20 / $74.80
| Facility | | $2.36 | $35.20 | $74.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $2.69 / $2.74
| Professional | | $2.62 | $2.69 | $2.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $2.09 / $2.09
| Professional | | $2.09 | $2.09 | $2.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.09 / $16.46 / $27.71
| Facility | | $5.09 | $16.46 | $27.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $3.14 / $7.00
| Professional | | $3.00 | $3.14 | $7.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.60 / $8.74 / $17.78
| Facility | | $1.60 | $8.74 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.48 / $1.96 / $4.13
| Professional | | $1.48 | $1.96 | $4.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.36 / $3.32 / $5.63
| Facility | | $2.36 | $3.32 | $5.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $4.13 / $6.00
| Professional | | $3.00 | $4.13 | $6.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.66 / $1.66 / $2.39
| Professional | | $1.66 | $1.66 | $2.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.27 / $1.81 / $3.62
| Professional | | $1.27 | $1.81 | $3.62 |