- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.20 / $20.67 / $904.40
| Facility | | $4.20 | $20.67 | $904.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $3.47 / $13.36
| Professional | | $2.54 | $3.47 | $13.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.29 / $2.29 / $2.29
| Professional | | $2.29 | $2.29 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.76 / $4.88 / $13.25
| Facility | | $2.76 | $4.88 | $13.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $1.89 / $7.66
| Professional | | $1.41 | $1.89 | $7.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.61 / $3.83 / $6.13
| Facility | | $2.61 | $3.83 | $6.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.87 / $8.43 / $12.26
| Facility | | $3.87 | $8.43 | $12.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.29 / $4.54 / $5.68
| Professional | | $2.29 | $4.54 | $5.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.19 / $4.98 / $13.73
| Professional | | $4.19 | $4.98 | $13.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.36 / $657.36 / $657.36
| Facility | | $657.36 | $657.36 | $657.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $3.15 / $7.89
| Professional | | $2.24 | $3.15 | $7.89 |