- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.28 / $21.02 / $36.56
| Facility | | $18.28 | $21.02 | $36.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.71 / $21.02 / $21.02
| Professional | | $15.71 | $21.02 | $21.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.73 / $20.32 / $27.34
| Facility | | $16.73 | $20.32 | $27.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.74 / $11.31 / $15.78
| Professional | | $10.74 | $11.31 | $15.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.30 / $19.26 / $57.51
| Facility | | $14.30 | $19.26 | $57.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.56 / $14.06 / $26.33
| Professional | | $9.56 | $14.06 | $26.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.68 / $10.73 / $25.54
| Professional | | $7.68 | $10.73 | $25.54 |