- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $14.79 / $21.38
| Facility | | $7.08 | $14.79 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $5.01 / $6.03
| Professional | | $3.98 | $5.01 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.38 / $32.36 / $33.88
| Facility | | $21.38 | $32.36 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $13.49 / $13.49
| Professional | | $13.49 | $13.49 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.47 / $11.22 / $15.49
| Facility | | $4.47 | $11.22 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $7.94 / $22.91
| Professional | | $3.55 | $7.94 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.03 / $6.17 / $18.62
| Facility | | $6.03 | $6.17 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.88 / $5.62 / $12.02
| Professional | | $2.88 | $5.62 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.98 / $6.92 / $9.77
| Facility | | $3.98 | $6.92 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.88 / $5.62 / $10.47
| Professional | | $2.88 | $5.62 | $10.47 |