- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.54 / $2.24 / $7.74
| Professional | | $1.54 | $2.24 | $7.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.85 / $3.05 / $3.75
| Professional | | $2.85 | $3.05 | $3.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.67 / $2.94 / $4.83
| Professional | | $2.67 | $2.94 | $4.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.83 / $2.87 / $3.77
| Facility | | $1.83 | $2.87 | $3.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.32 / $1.72 / $6.93
| Professional | | $1.32 | $1.72 | $6.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.92 / $3.00 / $3.84
| Facility | | $2.92 | $3.00 | $3.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.38 / $3.05 / $4.43
| Professional | | $2.38 | $3.05 | $4.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $3.70 / $5.30
| Professional | | $1.00 | $3.70 | $5.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.28 / $1.34 / $2.29
| Professional | | $1.28 | $1.34 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.40 / $2.40 / $2.40
| Facility | | $2.40 | $2.40 | $2.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.90 / $2.40 / $2.40
| Professional | | $1.90 | $2.40 | $2.40 |