- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.33 / $16.35 / $25.51
| Facility | | $15.33 | $16.35 | $25.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.77 / $13.77 / $20.44
| Professional | | $13.77 | $13.77 | $20.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.88 / $19.23 / $34.20
| Facility | | $13.88 | $19.23 | $34.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.26 / $12.91 / $13.81
| Professional | | $12.26 | $12.91 | $13.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.06 / $26.33 / $38.72
| Professional | | $21.06 | $26.33 | $38.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.35 / $16.35 / $30.04
| Facility | | $16.35 | $16.35 | $30.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.52 / $16.52 / $22.30
| Professional | | $16.52 | $16.52 | $22.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.23 / $10.33 / $17.21
| Professional | | $7.23 | $10.33 | $17.21 |