- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $4.88 / $11.95
| Facility | | $2.81 | $4.88 | $11.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $2.25 / $3.10
| Professional | | $1.94 | $2.25 | $3.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.62 / $2.68 / $10.32
| Facility | | $1.62 | $2.68 | $10.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.65 / $2.86 / $5.68
| Professional | | $1.65 | $2.86 | $5.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.35 / $13.43 / $21.64
| Facility | | $2.35 | $13.43 | $21.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.98 / $2.41 / $4.01
| Professional | | $1.98 | $2.41 | $4.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $2.12 / $2.65
| Professional | | $1.93 | $2.12 | $2.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.01 / $4.01 / $6.02
| Facility | | $4.01 | $4.01 | $6.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.50 / $2.41 / $4.49
| Professional | | $1.50 | $2.41 | $4.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.08 / $2.41 / $2.41
| Professional | | $2.08 | $2.41 | $2.41 |