- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.79 / $11.25 / $18.66
| Facility | | $3.79 | $11.25 | $18.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $3.72 / $4.00
| Professional | | $3.55 | $3.72 | $4.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.92 / $4.63 / $11.07
| Facility | | $2.92 | $4.63 | $11.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.80 / $4.78 / $6.71
| Professional | | $2.80 | $4.78 | $6.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.00 / $3.00 / $4.50
| Facility | | $3.00 | $3.00 | $4.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $3.01 / $6.02
| Professional | | $2.59 | $3.01 | $6.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.32 / $2.90
| Professional | | $2.11 | $2.32 | $2.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.30 / $4.30 / $6.46
| Facility | | $4.30 | $4.30 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.51 / $2.52 / $6.01
| Professional | | $1.51 | $2.52 | $6.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.23 / $2.64 / $2.64
| Professional | | $2.23 | $2.64 | $2.64 |