- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.28 / $1.43 / $2.70
| Facility | | $1.28 | $1.43 | $2.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $1.49 / $4.53
| Professional | | $1.35 | $1.49 | $4.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.27 / $2.00 / $2.38
| Facility | | $1.27 | $2.00 | $2.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $1.35 / $1.47
| Professional | | $1.35 | $1.35 | $1.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.01 / $2.81 / $3.41
| Professional | | $1.01 | $2.81 | $3.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.28 / $1.93 / $10.56
| Facility | | $1.28 | $1.93 | $10.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $1.49 / $5.97
| Professional | | $1.35 | $1.49 | $5.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.19 / $1.35 / $2.80
| Facility | | $1.19 | $1.35 | $2.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.35 / $2.00 / $5.64
| Facility | | $1.35 | $2.00 | $5.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.37 / $1.54 / $5.95
| Professional | | $1.37 | $1.54 | $5.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $1.35 / $1.55
| Professional | | $1.35 | $1.35 | $1.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $1.35 / $1.55
| Professional | | $1.35 | $1.35 | $1.55 |