- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $9.53 / $53.82
| Facility | | $2.50 | $9.53 | $53.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.40 / $16.00
| Professional | | $2.00 | $2.40 | $16.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $1.80 / $2.06
| Professional | | $1.35 | $1.80 | $2.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.51 / $5.39 / $9.88
| Facility | | $1.51 | $5.39 | $9.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.56 / $2.27 / $3.24
| Professional | | $1.56 | $2.27 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.90 / $4.40 / $7.92
| Facility | | $1.90 | $4.40 | $7.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.83 / $2.89 / $4.13
| Professional | | $1.83 | $2.89 | $4.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.16 / $2.36 / $60.00
| Facility | | $2.16 | $2.36 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.12 / $1.58 / $2.47
| Professional | | $1.12 | $1.58 | $2.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.12 / $1.58 / $2.16
| Professional | | $1.12 | $1.58 | $2.16 |