- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.70 / $2.13 / $2.86
| Facility | | $1.70 | $2.13 | $2.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.63 / $2.33 / $3.31
| Professional | | $1.63 | $2.33 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.72 / $2.10 / $2.65
| Professional | | $1.72 | $2.10 | $2.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $2.40
| Facility | | $2.27 | $2.27 | $2.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $1.93 / $2.40
| Professional | | $1.93 | $1.93 | $2.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.15 / $7.97 / $13.37
| Facility | | $2.15 | $7.97 | $13.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $2.27 / $3.78
| Professional | | $1.94 | $2.27 | $3.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.31 / $2.02 / $2.23
| Professional | | $1.31 | $2.02 | $2.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.36 / $1.81 / $2.29
| Professional | | $1.36 | $1.81 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.02 / $2.02 / $2.23
| Professional | | $2.02 | $2.02 | $2.23 |