- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.50 / $14.72 / $47.25
| Facility | | $10.50 | $14.72 | $47.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.11 / $10.50 / $12.16
| Professional | | $10.11 | $10.50 | $12.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.11 / $12.20 / $38.40
| Facility | | $10.11 | $12.20 | $38.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.32 / $6.63 / $9.48
| Professional | | $6.32 | $6.63 | $9.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.80 / $15.51 / $17.28
| Facility | | $12.80 | $15.51 | $17.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.80 / $14.72 / $18.14
| Professional | | $12.80 | $14.72 | $18.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.36 / $12.80 / $32.69
| Facility | | $9.36 | $12.80 | $32.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.43 / $14.87 / $26.38
| Professional | | $8.43 | $14.87 | $26.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.80 / $12.80 / $62.17
| Facility | | $12.80 | $12.80 | $62.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.38 / $7.83 / $14.02
| Professional | | $5.38 | $7.83 | $14.02 |