- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.52 / $87.82 / $902.48
| Facility | | $6.52 | $87.82 | $902.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.96 / $68.09 / $177.06
| Professional | | $4.96 | $68.09 | $177.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.52 / $15.09 / $23.91
| Facility | | $5.52 | $15.09 | $23.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $2.19 / $4.50
| Professional | | $2.19 | $2.19 | $4.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.05 / $4.98 / $13.42
| Facility | | $3.05 | $4.98 | $13.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.19 / $5.43 / $7.23
| Professional | | $3.19 | $5.43 | $7.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.97 / $6.02 / $9.44
| Facility | | $3.97 | $6.02 | $9.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $6.79 / $14.00
| Professional | | $3.50 | $6.79 | $14.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.57 / $6.57 / $6.57
| Facility | | $6.57 | $6.57 | $6.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $3.07 / $4.03
| Professional | | $2.19 | $3.07 | $4.03 |