- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.24 / $28.44 / $44.35
| Facility | | $14.24 | $28.44 | $44.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.76 / $12.55 / $44.05
| Professional | | $10.76 | $12.55 | $44.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.59 / $29.38 / $36.72
| Professional | | $18.59 | $29.38 | $36.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.27 / $16.30 / $28.53
| Professional | | $8.27 | $16.30 | $28.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.47 / $16.96 / $36.02
| Facility | | $5.47 | $16.96 | $36.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.84 / $9.77 / $33.58
| Professional | | $2.84 | $9.77 | $33.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.43 / $21.19 / $35.72
| Facility | | $4.43 | $21.19 | $35.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.21 / $21.03 / $35.72
| Professional | | $6.21 | $21.03 | $35.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.93 / $9.77 / $16.79
| Professional | | $2.93 | $9.77 | $16.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $16.30 / $16.30
| Professional | | $12.88 | $16.30 | $16.30 |