- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.82 / $11.22 / $13.31
| Facility | | $10.82 | $11.22 | $13.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.35 / $3.80 / $5.07
| Professional | | $3.35 | $3.80 | $5.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.42 / $4.05 / $5.58
| Professional | | $3.42 | $4.05 | $5.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.49 / $3.33 / $6.56
| Facility | | $2.49 | $3.33 | $6.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $3.95 / $7.23
| Professional | | $2.48 | $3.95 | $7.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.07 / $6.34 / $7.61
| Professional | | $5.07 | $6.34 | $7.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $2.54 / $3.30
| Professional | | $2.13 | $2.54 | $3.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.98 / $2.54 / $4.03
| Professional | | $1.98 | $2.54 | $4.03 |