- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $94.95 / $637.73
| Facility | | $2.50 | $94.95 | $637.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.50 / $5.51
| Professional | | $2.47 | $2.50 | $5.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.31 / $2.93
| Professional | | $2.11 | $2.31 | $2.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.84 / $4.94 / $8.15
| Facility | | $2.84 | $4.94 | $8.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $4.66 / $6.27
| Professional | | $2.47 | $4.66 | $6.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.11 / $2.47 / $3.71
| Facility | | $2.11 | $2.47 | $3.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.43 / $2.47 / $3.09
| Professional | | $2.43 | $2.47 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.47 / $2.47 / $2.47
| Facility | | $2.47 | $2.47 | $2.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.47 / $9.35
| Professional | | $2.47 | $2.47 | $9.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.65 / $36.11
| Professional | | $2.47 | $2.65 | $36.11 |