- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.63 / $2.04 / $2.74
| Facility | | $1.63 | $2.04 | $2.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.63 / $2.24 / $3.17
| Professional | | $1.63 | $2.24 | $3.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.65 / $2.06 / $3.62
| Professional | | $1.65 | $2.06 | $3.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.18 / $2.18 / $2.29
| Facility | | $2.18 | $2.18 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $1.85 / $2.29
| Professional | | $1.85 | $1.85 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.26 / $2.33 / $2.49
| Facility | | $1.26 | $2.33 | $2.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $2.46 / $3.62
| Professional | | $2.09 | $2.46 | $3.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.36 / $2.10 / $2.31
| Professional | | $1.36 | $2.10 | $2.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $1.76 / $2.19
| Professional | | $1.41 | $1.76 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $2.10 / $2.10
| Professional | | $2.10 | $2.10 | $2.10 |