- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.16 / $29.24 / $64.86
| Facility | | $9.16 | $29.24 | $64.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.03 / $6.43 / $9.96
| Professional | | $4.03 | $6.43 | $9.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.19 / $4.55 / $16.73
| Facility | | $4.19 | $4.55 | $16.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.43 / $4.96 / $6.20
| Professional | | $2.43 | $4.96 | $6.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.22 / $8.78 / $49.47
| Facility | | $4.22 | $8.78 | $49.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.29 / $4.29 / $5.15
| Professional | | $4.29 | $4.29 | $5.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.29 / $4.29 / $4.29
| Professional | | $4.29 | $4.29 | $4.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.44 / $10.73 / $15.83
| Facility | | $6.44 | $10.73 | $15.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.65 / $7.57 / $7.61
| Professional | | $3.65 | $7.57 | $7.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $3.34 / $6.47
| Professional | | $2.57 | $3.34 | $6.47 |