- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.33 / $41.65 / $71.06
| Facility | | $3.33 | $41.65 | $71.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.35 / $3.80 / $3.87
| Professional | | $3.35 | $3.80 | $3.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.21 / $35.82 / $70.48
| Facility | | $12.21 | $35.82 | $70.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.26 / $5.00 / $11.22
| Professional | | $4.26 | $5.00 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.77 / $12.40 / $25.68
| Facility | | $7.77 | $12.40 | $25.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $2.72 / $6.20
| Professional | | $2.14 | $2.72 | $6.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.33 / $4.50 / $8.34
| Facility | | $3.33 | $4.50 | $8.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.87 / $6.11 / $8.00
| Professional | | $5.87 | $6.11 | $8.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $2.35 / $3.38
| Professional | | $2.35 | $2.35 | $3.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $4.21 / $6.23
| Professional | | $2.56 | $4.21 | $6.23 |