- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.09 / $19.48 / $41.37
| Facility | | $10.09 | $19.48 | $41.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.18 / $7.21 / $25.22
| Professional | | $6.18 | $7.21 | $25.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.74 / $16.97 / $21.22
| Professional | | $10.74 | $16.97 | $21.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $12.10 / $18.94
| Professional | | $9.36 | $12.10 | $18.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $11.24 / $24.29
| Facility | | $8.13 | $11.24 | $24.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.93 / $9.36 / $20.51
| Professional | | $3.93 | $9.36 | $20.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $13.45 / $20.51
| Facility | | $8.13 | $13.45 | $20.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.02 / $15.70 / $20.51
| Professional | | $10.02 | $15.70 | $20.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.01 / $5.62 / $17.32
| Professional | | $4.01 | $5.62 | $17.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.39 / $9.36 / $9.36
| Professional | | $7.39 | $9.36 | $9.36 |