- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.30 / $11.73 / $71.78
| Facility | | $6.30 | $11.73 | $71.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.84 / $3.32 / $11.65
| Professional | | $2.84 | $3.32 | $11.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.96 / $7.83 / $9.78
| Professional | | $4.96 | $7.83 | $9.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.30 / $7.54 / $27.13
| Professional | | $4.30 | $7.54 | $27.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.30 / $7.21 / $20.64
| Facility | | $4.30 | $7.21 | $20.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $4.44 / $11.25
| Professional | | $2.59 | $4.44 | $11.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.27 / $8.78 / $13.51
| Facility | | $5.27 | $8.78 | $13.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.18 / $8.78 / $11.25
| Professional | | $5.18 | $8.78 | $11.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $2.87 / $10.44
| Professional | | $2.59 | $2.87 | $10.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.40 / $4.30 / $4.30
| Professional | | $3.40 | $4.30 | $4.30 |