- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.23 / $8.71 / $16.48
| Facility | | $3.23 | $8.71 | $16.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.23 / $4.20 / $5.59
| Professional | | $3.23 | $4.20 | $5.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.51 / $5.45 / $16.82
| Facility | | $3.51 | $5.45 | $16.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.80 / $2.40 / $7.56
| Professional | | $1.80 | $2.40 | $7.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.21 / $4.86 / $7.78
| Facility | | $3.21 | $4.86 | $7.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.84 / $10.69 / $15.53
| Facility | | $4.84 | $10.69 | $15.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.06 / $5.78 / $7.23
| Professional | | $3.06 | $5.78 | $7.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.31 / $6.32 / $12.42
| Professional | | $5.31 | $6.32 | $12.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.37 / $4.37 / $6.02
| Facility | | $4.37 | $4.37 | $6.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.92 / $6.79
| Professional | | $2.04 | $2.92 | $6.79 |