- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.77 / $14.73 / $38.42
| Facility | | $8.77 | $14.73 | $38.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.45 / $8.58 / $61.92
| Professional | | $6.45 | $8.58 | $61.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.69 / $6.69 / $6.69
| Professional | | $6.69 | $6.69 | $6.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.38 / $21.18 / $35.22
| Facility | | $5.38 | $21.18 | $35.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.58 / $8.11 / $11.56
| Professional | | $5.58 | $8.11 | $11.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.73 / $15.65 / $28.17
| Facility | | $6.73 | $15.65 | $28.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.49 / $11.56 / $14.45
| Professional | | $6.49 | $11.56 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.22 / $8.73 / $116.45
| Facility | | $7.22 | $8.73 | $116.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.04 / $5.65 / $8.86
| Professional | | $4.04 | $5.65 | $8.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.04 / $5.65 / $7.86
| Professional | | $4.04 | $5.65 | $7.86 |