- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.68 / $14.26 / $35.26
| Facility | | $11.68 | $14.26 | $35.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.07 / $10.07 / $10.64
| Professional | | $10.07 | $10.07 | $10.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.71 / $16.82 / $32.08
| Facility | | $11.71 | $16.82 | $32.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.52 / $7.37 / $17.78
| Professional | | $5.52 | $7.37 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.73 / $14.35 / $41.60
| Facility | | $7.73 | $14.35 | $41.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.50 / $13.60 / $17.55
| Professional | | $8.50 | $13.60 | $17.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.65 / $9.83 / $13.95
| Professional | | $5.65 | $9.83 | $13.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.16 / $11.41 / $21.57
| Professional | | $5.16 | $11.41 | $21.57 |