- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.87 / $32.97 / $71.68
| Facility | | $3.87 | $32.97 | $71.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.02 / $2.40 / $7.56
| Professional | | $2.02 | $2.40 | $7.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.62 / $1.88 / $4.73
| Professional | | $1.62 | $1.88 | $4.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.68 / $8.63 / $12.79
| Facility | | $7.68 | $8.63 | $12.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.20 / $4.58 / $5.57
| Professional | | $4.20 | $4.58 | $5.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.78 / $3.47 / $14.59
| Facility | | $1.78 | $3.47 | $14.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.67 / $3.61 / $13.00
| Professional | | $1.67 | $3.61 | $13.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.36 / $2.36 / $21.50
| Facility | | $2.36 | $2.36 | $21.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $1.62 / $5.05
| Professional | | $1.35 | $1.62 | $5.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $1.62 / $4.32
| Professional | | $1.35 | $1.62 | $4.32 |