- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.34 / $10.23 / $11.76
| Facility | | $5.34 | $10.23 | $11.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.32 / $5.32 / $11.63
| Professional | | $5.32 | $5.32 | $11.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.51 / $5.72 / $6.02
| Facility | | $4.51 | $5.72 | $6.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.71 / $5.96 / $6.04
| Professional | | $5.71 | $5.96 | $6.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.29 / $5.32 / $6.61
| Professional | | $5.29 | $5.32 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.94 / $5.34 / $85.00
| Facility | | $4.94 | $5.34 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.18 / $5.34 / $5.87
| Professional | | $5.18 | $5.34 | $5.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.73 / $7.82 / $10.42
| Facility | | $5.73 | $7.82 | $10.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.16 / $6.22 / $10.98
| Professional | | $5.16 | $6.22 | $10.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $5.32 / $5.85
| Professional | | $5.05 | $5.32 | $5.85 |