- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.53 / $2.83 / $3.80
| Facility | | $1.53 | $2.83 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $3.10 / $4.38
| Professional | | $2.25 | $3.10 | $4.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.63 / $2.88
| Professional | | $2.27 | $2.63 | $2.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.01 / $3.01 / $3.19
| Facility | | $3.01 | $3.01 | $3.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $2.56 / $3.19
| Professional | | $2.56 | $2.56 | $3.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $3.24 / $3.24
| Facility | | $3.24 | $3.24 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.87 / $3.59 / $5.01
| Professional | | $2.87 | $3.59 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $2.47 / $2.71
| Professional | | $1.60 | $2.47 | $2.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.76 / $2.40 / $3.01
| Professional | | $1.76 | $2.40 | $3.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.47 / $3.24
| Professional | | $2.47 | $2.47 | $3.24 |