- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.48 / $13.94 / $45.10
| Facility | | $7.48 | $13.94 | $45.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.61 / $6.00 / $8.60
| Professional | | $5.61 | $6.00 | $8.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.33 / $7.48 / $9.35
| Facility | | $3.33 | $7.48 | $9.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.40 / $4.51 / $5.49
| Professional | | $3.40 | $4.51 | $5.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.86 / $8.75 / $27.07
| Facility | | $4.86 | $8.75 | $27.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.22 / $8.67 / $10.84
| Professional | | $5.22 | $8.67 | $10.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.07 / $7.48 / $7.85
| Professional | | $0.07 | $7.48 | $7.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.37 / $2.37
| Professional | | $2.37 | $2.37 | $2.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.22 / $11.22 / $11.22
| Facility | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.14 / $4.04 / $8.51
| Professional | | $3.14 | $4.04 | $8.51 |