- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.77 / $6.39 / $12.78
| Facility | | $2.77 | $6.39 | $12.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.76 / $18.76
| Professional | | $2.45 | $2.76 | $18.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.53 / $1.98 / $2.12
| Professional | | $1.53 | $1.98 | $2.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.70 / $6.69 / $11.15
| Facility | | $1.70 | $6.69 | $11.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.77 / $2.57 / $3.66
| Professional | | $1.77 | $2.57 | $3.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.14 / $4.95 / $8.91
| Facility | | $2.14 | $4.95 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.72 / $4.65
| Professional | | $2.00 | $3.72 | $4.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.29 / $2.76 / $100.00
| Facility | | $2.29 | $2.76 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.83 / $2.54 / $3.05
| Professional | | $1.83 | $2.54 | $3.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.83 / $2.54 / $3.05
| Professional | | $1.83 | $2.54 | $3.05 |