- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.81 / $2.25 / $3.03
| Facility | | $1.81 | $2.25 | $3.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.81 / $2.48 / $3.51
| Professional | | $1.81 | $2.48 | $3.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.82 / $2.61 / $3.49
| Professional | | $1.82 | $2.61 | $3.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $2.77
| Facility | | $2.41 | $2.41 | $2.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.04 / $2.58
| Professional | | $2.04 | $2.04 | $2.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.60 / $2.60 / $2.60
| Facility | | $2.60 | $2.60 | $2.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.74 / $4.01
| Professional | | $2.00 | $2.74 | $4.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.52 / $2.11 / $2.58
| Professional | | $1.52 | $2.11 | $2.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.38 / $1.96 / $2.44
| Professional | | $1.38 | $1.96 | $2.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $2.35 / $2.56
| Professional | | $2.35 | $2.35 | $2.56 |