- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.74 / $21.44 / $37.46
| Facility | | $7.74 | $21.44 | $37.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.64 / $8.65 / $12.22
| Professional | | $7.64 | $8.65 | $12.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.76 / $29.42 / $46.62
| Facility | | $10.76 | $29.42 | $46.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.26 / $4.26 / $8.38
| Professional | | $4.26 | $4.26 | $8.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.96 / $9.73 / $26.22
| Facility | | $5.96 | $9.73 | $26.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.23 / $9.31 / $14.46
| Professional | | $6.23 | $9.31 | $14.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.74 / $12.22 / $20.05
| Facility | | $7.74 | $12.22 | $20.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.82 / $13.23 / $37.56
| Professional | | $6.82 | $13.23 | $37.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.81 / $12.81 / $12.81
| Facility | | $12.81 | $12.81 | $12.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.28 / $5.87 / $7.53
| Professional | | $4.28 | $5.87 | $7.53 |