- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.92 / $12.23 / $65.31
| Facility | | $5.92 | $12.23 | $65.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.64 / $3.97 / $7.64
| Professional | | $3.64 | $3.97 | $7.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $3.06 / $3.06
| Professional | | $2.64 | $3.06 | $3.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.53 / $15.19 / $22.51
| Facility | | $13.53 | $15.19 | $22.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.53 / $8.00 / $8.00
| Professional | | $4.53 | $8.00 | $8.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.89 / $5.67 / $24.81
| Facility | | $2.89 | $5.67 | $24.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.74 / $6.71 / $17.00
| Professional | | $2.74 | $6.71 | $17.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.00 / $4.00 / $10.18
| Facility | | $4.00 | $4.00 | $10.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $2.64 / $8.98
| Professional | | $1.85 | $2.64 | $8.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.64 / $2.64 / $4.40
| Facility | | $2.64 | $2.64 | $4.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $2.64 / $9.16
| Professional | | $1.85 | $2.64 | $9.16 |