- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.37 / $11.48 / $25.70
| Facility | | $5.37 | $11.48 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $4.07 / $11.22
| Professional | | $3.02 | $4.07 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $2.34 / $2.69
| Professional | | $2.34 | $2.34 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $29.51 / $47.86
| Facility | | $11.75 | $29.51 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $3.63 / $4.17
| Professional | | $2.40 | $3.63 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.88 / $2.88 / $2.88
| Facility | | $2.88 | $2.88 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.82 / $5.37 / $8.32
| Professional | | $2.82 | $5.37 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $5.37 / $5.62
| Professional | | $2.45 | $5.37 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.98 / $5.37 / $7.76
| Facility | | $3.98 | $5.37 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.82 / $7.08 / $11.22
| Professional | | $2.82 | $7.08 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $4.07 / $4.07
| Facility | | $3.31 | $4.07 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $2.63 / $2.75
| Professional | | $1.86 | $2.63 | $2.75 |