- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.70 / $14.53 / $33.78
| Facility | | $10.70 | $14.53 | $33.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.96 / $10.15 / $10.72
| Professional | | $5.96 | $10.15 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.26 / $16.52 / $31.38
| Facility | | $11.26 | $16.52 | $31.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.56 / $6.75 / $17.93
| Professional | | $5.56 | $6.75 | $17.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.40 / $14.58 / $40.61
| Facility | | $7.40 | $14.58 | $40.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.50 / $13.22 / $16.52
| Professional | | $8.50 | $13.22 | $16.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.18 / $9.01 / $16.73
| Professional | | $5.18 | $9.01 | $16.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.63 / $9.86 / $19.76
| Professional | | $5.63 | $9.86 | $19.76 |