- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.84 / $75.31 / $233.70
| Facility | | $4.84 | $75.31 | $233.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.67 / $35.60
| Professional | | $2.41 | $2.67 | $35.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $2.76 / $5.78
| Facility | | $1.00 | $2.76 | $5.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.97 / $2.46 / $2.59
| Professional | | $1.97 | $2.46 | $2.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.58 / $7.88 / $9.60
| Facility | | $4.58 | $7.88 | $9.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $2.90 / $3.00
| Professional | | $2.39 | $2.90 | $3.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.95 / $7.19 / $9.02
| Facility | | $3.95 | $7.19 | $9.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.36 / $2.36 / $3.21
| Professional | | $2.36 | $2.36 | $3.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $26.39 / $86.47
| Facility | | $12.88 | $26.39 | $86.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.46 / $2.46 / $4.46
| Professional | | $2.46 | $2.46 | $4.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $4.47
| Professional | | $2.41 | $2.41 | $4.47 |