- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.84 / $7.57 / $54.40
| Facility | | $2.84 | $7.57 | $54.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.84 / $3.81 / $4.91
| Professional | | $2.84 | $3.81 | $4.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $2.56 / $2.56
| Professional | | $2.56 | $2.56 | $2.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.78 / $4.72 / $14.77
| Facility | | $2.78 | $4.72 | $14.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $2.11 / $6.23
| Professional | | $1.58 | $2.11 | $6.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.74 / $4.26 / $6.83
| Facility | | $2.74 | $4.26 | $6.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.19 / $9.39 / $13.58
| Facility | | $4.19 | $9.39 | $13.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.60 / $5.37 / $6.71
| Professional | | $2.60 | $5.37 | $6.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.91 / $6.17 / $8.19
| Professional | | $4.91 | $6.17 | $8.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.50 / $3.43 / $5.96
| Professional | | $2.50 | $3.43 | $5.96 |