- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.31 / $7.82 / $56.17
| Facility | | $2.31 | $7.82 | $56.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $2.13 / $2.37
| Professional | | $1.94 | $2.13 | $2.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.37 / $2.37
| Professional | | $2.37 | $2.37 | $2.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.87 / $2.16 / $7.11
| Facility | | $1.87 | $2.16 | $7.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.12 / $1.12 / $1.63
| Professional | | $1.12 | $1.12 | $1.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.37 / $2.61 / $3.32
| Facility | | $2.37 | $2.61 | $3.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.54 / $2.49 / $3.20
| Professional | | $1.54 | $2.49 | $3.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.73 / $2.37 / $5.87
| Facility | | $1.73 | $2.37 | $5.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.56 / $2.65 / $6.29
| Professional | | $1.56 | $2.65 | $6.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.30 / $2.37 / $3.46
| Professional | | $1.30 | $2.37 | $3.46 |