- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.22 / $2.78 / $3.73
| Facility | | $2.22 | $2.78 | $3.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.22 / $3.12 / $4.32
| Professional | | $2.22 | $3.12 | $4.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $2.25 / $3.46
| Professional | | $1.85 | $2.25 | $3.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.97 / $2.97 / $3.14
| Facility | | $2.97 | $2.97 | $3.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $2.52 / $3.14
| Professional | | $2.52 | $2.52 | $3.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $9.93 / $16.67
| Facility | | $2.81 | $9.93 | $16.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.31 / $2.96 / $4.94
| Professional | | $2.31 | $2.96 | $4.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.52 / $2.10 / $2.57
| Professional | | $1.52 | $2.10 | $2.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.75 / $2.36 / $2.96
| Professional | | $1.75 | $2.36 | $2.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $2.34 / $3.06
| Professional | | $2.34 | $2.34 | $3.06 |