- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.36 / $3.77 / $10.98
| Facility | | $3.36 | $3.77 | $10.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.22 / $3.36 / $3.87
| Professional | | $2.22 | $3.36 | $3.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.40 / $17.54 / $17.54
| Facility | | $9.40 | $17.54 | $17.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $2.73 / $3.82
| Professional | | $2.52 | $2.73 | $3.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.87 / $4.44 / $10.68
| Facility | | $2.87 | $4.44 | $10.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $3.10 / $6.20
| Professional | | $2.66 | $3.10 | $6.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.36 / $4.55 / $8.23
| Facility | | $3.36 | $4.55 | $8.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.26 / $6.02 / $8.00
| Professional | | $4.26 | $6.02 | $8.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $2.87 / $5.88
| Professional | | $2.10 | $2.87 | $5.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.82 / $70.00 / $100.00
| Facility | | $13.82 | $70.00 | $100.00 |