- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.71 / $50.10 / $338.87
| Facility | | $5.71 | $50.10 | $338.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.03 / $3.61 / $4.30
| Professional | | $3.03 | $3.61 | $4.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.22 / $11.53 / $18.27
| Facility | | $4.22 | $11.53 | $18.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.67 / $1.67 / $3.40
| Professional | | $1.67 | $1.67 | $3.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.33 / $3.81 / $10.26
| Facility | | $2.33 | $3.81 | $10.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.44 / $3.66 / $5.68
| Professional | | $2.44 | $3.66 | $5.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.03 / $4.79 / $7.88
| Facility | | $3.03 | $4.79 | $7.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.67 / $5.19 / $14.72
| Professional | | $2.67 | $5.19 | $14.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.03 / $5.03 / $5.03
| Facility | | $5.03 | $5.03 | $5.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.68 / $2.35 / $3.99
| Professional | | $1.68 | $2.35 | $3.99 |