- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.02 / $27.48 / $63.21
| Facility | | $20.02 | $27.48 | $63.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.16 / $19.00 / $20.07
| Professional | | $11.16 | $19.00 | $20.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.07 / $30.92 / $58.74
| Facility | | $21.07 | $30.92 | $58.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.40 / $12.64 / $33.54
| Professional | | $10.40 | $12.64 | $33.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.85 / $27.27 / $76.47
| Facility | | $13.85 | $27.27 | $76.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.05 / $24.37 / $30.46
| Professional | | $16.05 | $24.37 | $30.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.69 / $16.86 / $25.77
| Professional | | $9.69 | $16.86 | $25.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.54 / $18.45 / $36.97
| Professional | | $10.54 | $18.45 | $36.97 |