- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.57 / $10.09 / $36.26
| Facility | | $4.57 | $10.09 | $36.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.82 / $3.87 / $5.46
| Professional | | $2.82 | $3.87 | $5.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $2.56 / $2.97
| Professional | | $2.56 | $2.56 | $2.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.82 / $12.16 / $18.01
| Facility | | $10.82 | $12.16 | $18.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.86 / $6.86 / $11.22
| Professional | | $6.86 | $6.86 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.80 / $5.48 / $23.34
| Facility | | $2.80 | $5.48 | $23.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $6.20 / $14.00
| Professional | | $2.59 | $6.20 | $14.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.87 / $3.87 / $8.26
| Facility | | $3.87 | $3.87 | $8.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $4.26 / $8.71
| Professional | | $2.56 | $4.26 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $4.26 / $8.89
| Professional | | $2.56 | $4.26 | $8.89 |