- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.12 / $7.43 / $14.87
| Facility | | $3.12 | $7.43 | $14.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $3.75 / $7.43
| Professional | | $2.81 | $3.75 | $7.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.38 / $5.18 / $16.23
| Facility | | $3.38 | $5.18 | $16.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.59 / $2.13 / $7.51
| Professional | | $1.59 | $2.13 | $7.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.21 / $4.69 / $7.50
| Facility | | $3.21 | $4.69 | $7.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.51 / $10.32 / $14.63
| Facility | | $4.51 | $10.32 | $14.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.60 / $5.78 / $7.23
| Professional | | $2.60 | $5.78 | $7.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.12 / $6.10 / $12.42
| Professional | | $5.12 | $6.10 | $12.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.22 / $4.22 / $4.22
| Facility | | $4.22 | $4.22 | $4.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.02 / $2.83 / $9.85
| Professional | | $2.02 | $2.83 | $9.85 |