- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.64 / $13.73 / $47.88
| Facility | | $10.64 | $13.73 | $47.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.60 / $10.64 / $12.27
| Professional | | $9.60 | $10.64 | $12.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.25 / $11.68 / $38.94
| Facility | | $10.25 | $11.68 | $38.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.85 / $6.41 / $9.30
| Professional | | $5.85 | $6.41 | $9.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.98 / $15.58 / $17.52
| Facility | | $12.98 | $15.58 | $17.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.98 / $14.93 / $18.39
| Professional | | $12.98 | $14.93 | $18.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.50 / $12.98 / $33.54
| Facility | | $9.50 | $12.98 | $33.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.55 / $14.87 / $34.47
| Professional | | $8.55 | $14.87 | $34.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.45 / $7.94 / $12.98
| Professional | | $5.45 | $7.94 | $12.98 |