- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.30 / $6.55 / $66.87
| Facility | | $3.30 | $6.55 | $66.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $3.42 / $4.82
| Professional | | $3.10 | $3.42 | $4.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $2.00
| Professional | | $2.00 | $2.00 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.18 / $4.01 / $12.06
| Facility | | $3.18 | $4.01 | $12.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $3.83
| Professional | | $2.41 | $2.41 | $3.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.01 / $4.42 / $5.63
| Facility | | $4.01 | $4.42 | $5.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $4.22 / $5.43
| Professional | | $2.61 | $4.22 | $5.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.61 / $4.01 / $9.23
| Facility | | $2.61 | $4.01 | $9.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $4.54 / $7.75
| Professional | | $2.09 | $4.54 | $7.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $4.01 / $4.63
| Professional | | $2.13 | $4.01 | $4.63 |