- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.29 / $398.42 / $582.73
| Facility | | $3.29 | $398.42 | $582.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.25 / $3.26 / $4.47
| Professional | | $3.25 | $3.26 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.12 / $3.26 / $4.88
| Facility | | $3.12 | $3.26 | $4.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $4.19 / $7.56
| Professional | | $3.26 | $4.19 | $7.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.08 / $3.60 / $3.60
| Facility | | $3.08 | $3.60 | $3.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.26 / $3.38
| Professional | | $3.26 | $3.26 | $3.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.57 / $11.36 / $12.55
| Facility | | $10.57 | $11.36 | $12.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.62 / $4.37
| Professional | | $3.26 | $3.62 | $4.37 |