- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.24 / $2.62 / $7.18
| Facility | | $2.24 | $2.62 | $7.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.29 / $2.62 / $2.62
| Professional | | $2.29 | $2.62 | $2.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.94 / $10.46 / $10.46
| Facility | | $6.94 | $10.46 | $10.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.48 / $2.13 / $3.91
| Professional | | $1.48 | $2.13 | $3.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.74 / $2.71 / $8.90
| Facility | | $1.74 | $2.71 | $8.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $1.83 / $4.58
| Professional | | $1.58 | $1.83 | $4.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.06 / $2.46 / $4.90
| Facility | | $2.06 | $2.46 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.42 / $3.59 / $5.00
| Professional | | $3.42 | $3.59 | $5.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.48 / $1.80 / $3.43
| Professional | | $1.48 | $1.80 | $3.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $70.00 / $100.00
| Facility | | $10.00 | $70.00 | $100.00 |