- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.41 / $11.37 / $126.15
| Facility | | $6.41 | $11.37 | $126.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.62 / $6.12 / $7.88
| Professional | | $3.62 | $6.12 | $7.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.05 / $6.85 / $8.56
| Facility | | $3.05 | $6.85 | $8.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.38 / $4.13 / $5.26
| Professional | | $3.38 | $4.13 | $5.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.45 / $8.01 / $24.79
| Facility | | $4.45 | $8.01 | $24.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.04 / $7.85 / $9.81
| Professional | | $5.04 | $7.85 | $9.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.07 / $6.85 / $7.19
| Professional | | $0.07 | $6.85 | $7.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $2.35 / $2.35
| Professional | | $2.35 | $2.35 | $2.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.70 / $4.70 / $4.70
| Facility | | $4.70 | $4.70 | $4.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.88 / $4.01 / $9.58
| Professional | | $2.88 | $4.01 | $9.58 |