- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.36 / $7.22 / $12.94
| Facility | | $3.36 | $7.22 | $12.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.36 / $3.36 / $4.41
| Professional | | $3.36 | $3.36 | $4.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.71 / $4.62 / $7.43
| Facility | | $3.71 | $4.62 | $7.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.06 / $4.53
| Professional | | $2.06 | $2.06 | $4.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.80 / $4.20 / $5.67
| Facility | | $2.80 | $4.20 | $5.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.57 / $5.46 / $5.67
| Professional | | $3.57 | $5.46 | $5.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.73 / $4.32 / $11.45
| Facility | | $2.73 | $4.32 | $11.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $3.37 / $6.20
| Professional | | $2.15 | $3.37 | $6.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.73 / $4.32 / $15.96
| Facility | | $2.73 | $4.32 | $15.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $2.73 / $5.65
| Professional | | $2.15 | $2.73 | $5.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $3.78 / $5.19
| Professional | | $3.15 | $3.78 | $5.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.76 / $2.52 / $6.12
| Professional | | $1.76 | $2.52 | $6.12 |