- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.31 / $12.80 / $65.28
| Facility | | $1.31 | $12.80 | $65.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.51 / $1.31 / $1.31
| Professional | | $0.51 | $1.31 | $1.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.47 / $1.53 / $1.55
| Professional | | $1.47 | $1.53 | $1.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.70 / $2.29 / $3.97
| Professional | | $1.70 | $2.29 | $3.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.24 / $2.23 / $2.94
| Facility | | $1.24 | $2.23 | $2.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.60 / $0.79 / $1.68
| Professional | | $0.60 | $0.79 | $1.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.74 / $2.04 / $3.33
| Facility | | $1.74 | $2.04 | $3.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.59 / $2.06 / $3.45
| Professional | | $1.59 | $2.06 | $3.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.40 / $3.10
| Professional | | $2.00 | $2.40 | $3.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.56 / $0.79 / $1.25
| Professional | | $0.56 | $0.79 | $1.25 |