- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.48 / $24.33 / $61.56
| Facility | | $19.48 | $24.33 | $61.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.88 / $18.51 / $18.62
| Professional | | $10.88 | $18.51 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.52 / $30.11 / $57.22
| Facility | | $20.52 | $30.11 | $57.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.14 / $12.31 / $32.68
| Professional | | $10.14 | $12.31 | $32.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.49 / $26.55 / $75.27
| Facility | | $13.49 | $26.55 | $75.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.67 / $23.54 / $29.43
| Professional | | $15.67 | $23.54 | $29.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $16.42 / $25.12
| Professional | | $9.44 | $16.42 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.26 / $17.98 / $36.01
| Professional | | $10.26 | $17.98 | $36.01 |