- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.07 / $38.57 / $82.10
| Facility | | $21.07 | $38.57 | $82.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.55 / $11.50 / $13.41
| Professional | | $10.55 | $11.50 | $13.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.16 / $15.83 / $26.10
| Facility | | $15.16 | $15.83 | $26.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $9.65 / $24.50
| Professional | | $6.76 | $9.65 | $24.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.01 / $30.73 / $54.02
| Facility | | $12.01 | $30.73 | $54.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.31 / $14.24 / $18.59
| Professional | | $9.31 | $14.24 | $18.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.41 / $10.50 / $20.59
| Professional | | $5.41 | $10.50 | $20.59 |