- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.11 / $2.52 / $3.21
| Facility | | $2.11 | $2.52 | $3.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.45 / $2.35 / $3.96
| Professional | | $1.45 | $2.35 | $3.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.61 / $1.89 / $2.02
| Professional | | $1.61 | $1.89 | $2.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.45 / $2.62 / $79.45
| Professional | | $1.45 | $2.62 | $79.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.57 / $2.37 / $5.00
| Facility | | $1.57 | $2.37 | $5.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.40 / $1.40 / $4.08
| Professional | | $1.40 | $1.40 | $4.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.49 / $1.72 / $2.43
| Facility | | $1.49 | $1.72 | $2.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.51 / $2.06 / $5.00
| Professional | | $1.51 | $2.06 | $5.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.28 / $1.45 / $1.49
| Professional | | $1.28 | $1.45 | $1.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.40 / $1.40 / $1.40
| Facility | | $1.40 | $1.40 | $1.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.40 / $1.40 / $1.40
| Professional | | $1.40 | $1.40 | $1.40 |