- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.41 / $14.61 / $46.85
| Facility | | $10.41 | $14.61 | $46.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.27 / $10.41 / $12.07
| Professional | | $9.27 | $10.41 | $12.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.02 / $11.43 / $38.10
| Facility | | $10.02 | $11.43 | $38.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.23 / $5.75 / $9.32
| Professional | | $5.23 | $5.75 | $9.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.70 / $15.24 / $17.14
| Facility | | $12.70 | $15.24 | $17.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.70 / $14.61 / $18.00
| Professional | | $12.70 | $14.61 | $18.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.26 / $12.70 / $29.34
| Facility | | $8.26 | $12.70 | $29.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.60 / $14.46 / $22.96
| Professional | | $6.60 | $14.46 | $22.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.89 / $7.57 / $12.70
| Facility | | $6.89 | $7.57 | $12.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.48 / $12.70 / $14.65
| Professional | | $6.48 | $12.70 | $14.65 |