- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.31 / $74.29 / $127.68
| Facility | | $5.31 | $74.29 | $127.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.33 / $2.67 / $3.49
| Professional | | $2.33 | $2.67 | $3.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.08 / $2.08 / $2.99
| Professional | | $2.08 | $2.08 | $2.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.40 / $21.74 / $47.38
| Facility | | $8.40 | $21.74 | $47.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.99 / $6.00 / $8.00
| Professional | | $2.99 | $6.00 | $8.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.58 / $8.65 / $17.78
| Facility | | $1.58 | $8.65 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.48 / $1.87 / $4.13
| Professional | | $1.48 | $1.87 | $4.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.33 / $3.44 / $5.84
| Facility | | $2.33 | $3.44 | $5.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $4.26 / $6.00
| Professional | | $3.00 | $4.26 | $6.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.64 / $1.64 / $2.37
| Professional | | $1.64 | $1.64 | $2.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.26 / $2.04 / $5.38
| Professional | | $1.26 | $2.04 | $5.38 |