- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.46 / $14.65 / $21.60
| Facility | | $9.46 | $14.65 | $21.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.16 / $6.76 / $7.77
| Professional | | $0.16 | $6.76 | $7.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.39 / $5.39 / $5.39
| Professional | | $5.39 | $5.39 | $5.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.19 / $12.05 / $17.96
| Facility | | $10.19 | $12.05 | $17.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.23 / $11.23 / $11.23
| Professional | | $11.23 | $11.23 | $11.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.11 / $10.02 / $43.76
| Facility | | $5.11 | $10.02 | $43.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.08 / $8.33 / $10.93
| Professional | | $4.08 | $8.33 | $10.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.76 / $8.05 / $15.14
| Facility | | $7.76 | $8.05 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $5.75 / $15.85
| Professional | | $3.26 | $5.75 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.80 / $7.77 / $11.66
| Facility | | $2.80 | $7.77 | $11.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $4.66 / $16.17
| Professional | | $3.26 | $4.66 | $16.17 |