- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.23 / $78.72 / $532.66
| Facility | | $4.23 | $78.72 | $532.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.80 / $55.86
| Professional | | $3.02 | $3.80 | $55.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.72 / $2.72 / $3.02
| Professional | | $2.72 | $2.72 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.08 / $4.57 / $11.94
| Facility | | $3.08 | $4.57 | $11.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.26 / $3.26
| Professional | | $3.26 | $3.26 | $3.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.85 / $2.85 / $3.02
| Facility | | $2.85 | $2.85 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.02 / $3.02
| Professional | | $3.02 | $3.02 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.73 / $4.04 / $7.38
| Facility | | $2.73 | $4.04 | $7.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.72 / $3.21 / $171.39
| Professional | | $2.72 | $3.21 | $171.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.20 / $5.32
| Professional | | $3.02 | $3.20 | $5.32 |