- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.68 / $8.31 / $11.50
| Facility | | $4.68 | $8.31 | $11.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $4.26 / $5.75
| Professional | | $2.64 | $4.26 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.23 / $5.00 / $6.25
| Facility | | $2.23 | $5.00 | $6.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $3.02 / $3.84
| Professional | | $2.41 | $3.02 | $3.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.25 / $5.85 / $18.10
| Facility | | $3.25 | $5.85 | $18.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.60 / $5.78 / $7.23
| Professional | | $3.60 | $5.78 | $7.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.07 / $5.00 / $5.25
| Professional | | $0.07 | $5.00 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.68 / $1.68 / $1.68
| Professional | | $1.68 | $1.68 | $1.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.35 / $3.35 / $7.08
| Facility | | $3.35 | $3.35 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $2.87 / $6.03
| Professional | | $2.10 | $2.87 | $6.03 |