- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.92 / $13.63 / $23.81
| Facility | | $4.92 | $13.63 | $23.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $5.50 / $7.38
| Professional | | $4.84 | $5.50 | $7.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.84 / $18.70 / $29.63
| Facility | | $6.84 | $18.70 | $29.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.71 / $2.71 / $4.96
| Professional | | $2.71 | $2.71 | $4.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.79 / $5.68 / $16.67
| Facility | | $3.79 | $5.68 | $16.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.40 / $4.55 / $8.44
| Professional | | $3.40 | $4.55 | $8.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.92 / $7.04 / $11.11
| Facility | | $4.92 | $7.04 | $11.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.33 / $8.41 / $23.87
| Professional | | $4.33 | $8.41 | $23.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.47 / $6.47 / $6.47
| Facility | | $6.47 | $6.47 | $6.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.72 / $3.80 / $6.47
| Professional | | $2.72 | $3.80 | $6.47 |