- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.26 / $34.64 / $102.84
| Facility | | $4.26 | $34.64 | $102.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.30 / $4.88 / $9.69
| Professional | | $4.30 | $4.88 | $9.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.36 / $4.84 / $5.66
| Facility | | $3.36 | $4.84 | $5.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $2.66 / $5.32
| Professional | | $2.54 | $2.66 | $5.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.39 / $6.47 / $7.71
| Facility | | $5.39 | $6.47 | $7.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.39 / $6.52 / $10.78
| Professional | | $5.39 | $6.52 | $10.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.50 / $4.19 / $10.24
| Facility | | $3.50 | $4.19 | $10.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $6.20 / $34.89
| Professional | | $2.81 | $6.20 | $34.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.96 / $2.96 / $2.96
| Professional | | $2.96 | $2.96 | $2.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $4.50 / $7.33
| Professional | | $2.25 | $4.50 | $7.33 |