- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.24 / $14.12 / $22.03
| Facility | | $13.24 | $14.12 | $22.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.89 / $12.78 / $17.64
| Professional | | $11.89 | $12.78 | $17.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.06 / $16.96 / $29.54
| Facility | | $12.06 | $16.96 | $29.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.59 / $11.15 / $11.93
| Professional | | $10.59 | $11.15 | $11.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.17 / $22.71 / $33.44
| Professional | | $18.17 | $22.71 | $33.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.12 / $14.12 / $25.95
| Facility | | $14.12 | $14.12 | $25.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.27 / $14.27 / $19.26
| Professional | | $14.27 | $14.27 | $19.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.24 / $8.92 / $14.86
| Professional | | $6.24 | $8.92 | $14.86 |