- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.38 / $30.31 / $38.24
| Facility | | $25.38 | $30.31 | $38.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.65 / $2.76 / $4.57
| Professional | | $2.65 | $2.76 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.61 / $6.15 / $6.89
| Professional | | $4.61 | $6.15 | $6.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.30 / $3.34 / $4.20
| Professional | | $3.30 | $3.34 | $4.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.17 / $6.01 / $19.71
| Facility | | $2.17 | $6.01 | $19.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.83 / $3.34 / $6.10
| Professional | | $1.83 | $3.34 | $6.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.83 / $3.34 / $5.23
| Professional | | $1.83 | $3.34 | $5.23 |