- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.77 / $32.54 / $83.26
| Facility | | $17.77 | $32.54 | $83.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.14 / $10.55 / $11.87
| Professional | | $10.14 | $10.55 | $11.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.77 / $17.05 / $22.02
| Facility | | $14.77 | $17.05 | $22.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.60 / $10.86 / $20.66
| Professional | | $7.60 | $10.86 | $20.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.26 / $25.91 / $45.55
| Facility | | $10.26 | $25.91 | $45.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.87 / $12.01 / $21.17
| Professional | | $7.87 | $12.01 | $21.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.08 / $10.50 / $21.48
| Professional | | $6.08 | $10.50 | $21.48 |