- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.08 / $3.04 / $10.44
| Professional | | $2.08 | $3.04 | $10.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.88 / $4.13 / $5.16
| Professional | | $3.88 | $4.13 | $5.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.08 / $3.62 / $6.55
| Professional | | $3.08 | $3.62 | $6.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.46 / $3.81 / $4.78
| Facility | | $2.46 | $3.81 | $4.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.77 / $2.29 / $9.32
| Professional | | $1.77 | $2.29 | $9.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.98 / $4.00 / $5.21
| Facility | | $3.98 | $4.00 | $5.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.20 / $4.15 / $6.05
| Professional | | $3.20 | $4.15 | $6.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $4.90 / $7.10
| Professional | | $1.60 | $4.90 | $7.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.72 / $1.81 / $3.10
| Professional | | $1.72 | $1.81 | $3.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.26 / $3.26 / $3.26
| Facility | | $3.26 | $3.26 | $3.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.58 / $3.26 / $3.26
| Professional | | $2.58 | $3.26 | $3.26 |