- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.03 / $11.04 / $27.89
| Facility | | $6.03 | $11.04 | $27.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.84 / $3.98 / $3.98
| Professional | | $3.84 | $3.98 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.01 / $5.71 / $10.77
| Facility | | $5.01 | $5.71 | $10.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $3.64 / $6.63
| Professional | | $2.54 | $3.64 | $6.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.50 / $8.81 / $15.48
| Facility | | $3.50 | $8.81 | $15.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.68 / $4.07 / $7.23
| Professional | | $2.68 | $4.07 | $7.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.70 / $5.15 / $7.76
| Professional | | $1.70 | $5.15 | $7.76 |