- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.08 / $3.12 / $6.07
| Professional | | $2.08 | $3.12 | $6.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.73 / $1.73 / $1.73
| Professional | | $1.73 | $1.73 | $1.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.05 / $8.68 / $10.18
| Professional | | $7.05 | $8.68 | $10.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.12 / $4.23 / $14.40
| Facility | | $3.12 | $4.23 | $14.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.32 / $4.03 / $4.44
| Professional | | $3.32 | $4.03 | $4.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.81 / $4.23 / $4.65
| Facility | | $3.81 | $4.23 | $4.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.12 / $4.23 / $14.39
| Facility | | $3.12 | $4.23 | $14.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.73 / $3.71 / $4.54
| Professional | | $1.73 | $3.71 | $4.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.42 / $4.65 / $4.65
| Professional | | $4.42 | $4.65 | $4.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.72 / $1.79 / $3.43
| Professional | | $1.72 | $1.79 | $3.43 |