- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.37 / $21.13 / $75.11
| Facility | | $18.37 | $21.13 | $75.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.37 / $16.66 / $21.13
| Professional | | $16.37 | $16.66 | $21.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.88 / $16.84 / $22.66
| Facility | | $13.88 | $16.84 | $22.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.76 / $13.43 / $18.75
| Professional | | $12.76 | $13.43 | $18.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.36 / $19.34 / $57.51
| Facility | | $14.36 | $19.34 | $57.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.73 / $14.13 / $26.33
| Professional | | $9.73 | $14.13 | $26.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.72 / $11.02 / $25.66
| Professional | | $7.72 | $11.02 | $25.66 |