- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.03 / $20.89 / $151.36
| Facility | | $6.03 | $20.89 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $4.47 / $8.51
| Professional | | $3.02 | $4.47 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.29 / $3.09 / $5.13
| Professional | | $2.29 | $3.09 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $10.47 / $19.05
| Facility | | $6.31 | $10.47 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.27 / $5.75 / $10.00
| Professional | | $4.27 | $5.75 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.13 / $5.13 / $39.81
| Facility | | $5.13 | $5.13 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.39 / $11.48 / $32.36
| Facility | | $3.39 | $11.48 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $3.47 / $5.75
| Professional | | $2.75 | $3.47 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $5.13 / $6.46
| Facility | | $2.57 | $5.13 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $3.02 / $7.24
| Professional | | $2.19 | $3.02 | $7.24 |