- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $35.42 / $88.56
| Facility | | $3.31 | $35.42 | $88.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.20 / $2.31 / $3.61
| Professional | | $2.20 | $2.31 | $3.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.21 / $2.21 / $2.21
| Professional | | $2.21 | $2.21 | $2.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.83 / $3.22 / $4.86
| Professional | | $2.83 | $3.22 | $4.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.08 / $2.08 / $2.21
| Facility | | $2.08 | $2.08 | $2.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.21 / $2.21 / $2.21
| Professional | | $2.21 | $2.21 | $2.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.88 / $2.65 / $9.61
| Professional | | $1.88 | $2.65 | $9.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.57 / $3.19 / $3.43
| Facility | | $0.57 | $3.19 | $3.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $1.00
| Professional | | $1.00 | $1.00 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.10 / $2.67 / $3.47
| Facility | | $2.10 | $2.67 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $2.67 / $3.47
| Professional | | $2.10 | $2.67 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $2.21 / $2.77
| Professional | | $2.14 | $2.21 | $2.77 |