- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.35 / $62.80 / $770.40
| Facility | | $5.35 | $62.80 | $770.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.21 / $3.64 / $5.14
| Professional | | $3.21 | $3.64 | $5.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.51 / $12.37 / $19.60
| Facility | | $4.51 | $12.37 | $19.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.79 / $1.79 / $3.62
| Professional | | $1.79 | $1.79 | $3.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $4.09 / $11.01
| Facility | | $2.50 | $4.09 | $11.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.60 / $3.89 / $6.20
| Professional | | $2.60 | $3.89 | $6.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.25 / $5.14 / $8.39
| Facility | | $3.25 | $5.14 | $8.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.87 / $5.56 / $15.79
| Professional | | $2.87 | $5.56 | $15.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.28 / $4.28 / $5.36
| Facility | | $4.28 | $4.28 | $5.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.80 / $2.45 / $4.28
| Professional | | $1.80 | $2.45 | $4.28 |