- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.01 / $11.65 / $18.19
| Facility | | $4.01 | $11.65 | $18.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $3.58 / $25.33
| Professional | | $2.64 | $3.58 | $25.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $2.56 / $2.74
| Professional | | $2.56 | $2.56 | $2.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.21 / $8.67 / $14.45
| Facility | | $2.21 | $8.67 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $3.32 / $4.73
| Professional | | $2.27 | $3.32 | $4.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.77 / $6.40 / $11.52
| Facility | | $2.77 | $6.40 | $11.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $4.54 / $6.20
| Professional | | $2.66 | $4.54 | $6.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.96 / $3.57 / $60.00
| Facility | | $2.96 | $3.57 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.65 / $2.31 / $3.22
| Professional | | $1.65 | $2.31 | $3.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.55 / $3.55 / $4.96
| Facility | | $3.55 | $3.55 | $4.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.65 / $2.31 / $3.15
| Professional | | $1.65 | $2.31 | $3.15 |