- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.40 / $4.55 / $5.24
| Facility | | $2.40 | $4.55 | $5.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.37 / $4.03
| Professional | | $2.37 | $2.37 | $4.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.00 / $2.54 / $2.68
| Facility | | $2.00 | $2.54 | $2.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $2.64 / $2.72
| Professional | | $2.54 | $2.64 | $2.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.44 / $3.05
| Professional | | $2.37 | $2.44 | $3.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.02 / $4.55 / $85.00
| Facility | | $2.02 | $4.55 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.40 / $2.64
| Professional | | $2.37 | $2.40 | $2.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.60 / $2.86 / $4.13
| Facility | | $2.60 | $2.86 | $4.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.33 / $2.86 / $3.52
| Professional | | $2.33 | $2.86 | $3.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $2.37 / $2.61
| Professional | | $2.25 | $2.37 | $2.61 |