- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.76 / $8.18 / $14.48
| Facility | | $3.76 | $8.18 | $14.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.76 / $3.76 / $6.78
| Professional | | $3.76 | $3.76 | $6.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.15 / $5.17 / $8.32
| Facility | | $4.15 | $5.17 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.88 / $1.88 / $5.07
| Professional | | $1.88 | $1.88 | $5.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.77 / $4.70 / $6.35
| Facility | | $2.77 | $4.70 | $6.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $6.11 / $6.35
| Professional | | $4.00 | $6.11 | $6.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.06 / $4.84 / $16.07
| Facility | | $3.06 | $4.84 | $16.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $3.06 / $7.23
| Professional | | $2.15 | $3.06 | $7.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.41 / $4.84 / $17.54
| Facility | | $2.41 | $4.84 | $17.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $2.48 / $4.95
| Professional | | $2.15 | $2.48 | $4.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.53 / $3.88 / $5.64
| Professional | | $3.53 | $3.88 | $5.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.82 / $4.30 / $5.41
| Professional | | $2.82 | $4.30 | $5.41 |