- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.03 / $8.02 / $14.46
| Facility | | $3.03 | $8.02 | $14.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.03 / $3.65 / $8.15
| Professional | | $3.03 | $3.65 | $8.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.29 / $5.82 / $15.78
| Facility | | $3.29 | $5.82 | $15.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.68 / $2.25 / $9.11
| Professional | | $1.68 | $2.25 | $9.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.11 / $4.55 / $7.30
| Facility | | $3.11 | $4.55 | $7.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.51 / $10.02 / $13.89
| Facility | | $4.51 | $10.02 | $13.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $5.37 / $6.71
| Professional | | $2.75 | $5.37 | $6.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.98 / $5.93 / $16.32
| Professional | | $4.98 | $5.93 | $16.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $2.50 / $2.61
| Facility | | $2.50 | $2.50 | $2.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.67 / $3.32 / $8.33
| Professional | | $2.67 | $3.32 | $8.33 |