- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.55 / $21.36 / $47.48
| Facility | | $10.55 | $21.36 | $47.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.17 / $10.55 / $12.23
| Professional | | $10.17 | $10.55 | $12.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.17 / $11.58 / $38.61
| Facility | | $10.17 | $11.58 | $38.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.51 / $6.36 / $9.44
| Professional | | $5.51 | $6.36 | $9.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.87 / $15.51 / $17.37
| Facility | | $12.87 | $15.51 | $17.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.87 / $14.80 / $18.23
| Professional | | $12.87 | $14.80 | $18.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.42 / $12.87 / $33.54
| Facility | | $9.42 | $12.87 | $33.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.48 / $14.87 / $18.59
| Professional | | $8.48 | $14.87 | $18.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.41 / $6.72 / $12.87
| Professional | | $5.41 | $6.72 | $12.87 |