- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.05 / $13.86 / $24.10
| Facility | | $12.05 | $13.86 | $24.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.09 / $10.50 / $13.86
| Professional | | $10.09 | $10.50 | $13.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.23 / $7.53 / $7.53
| Professional | | $7.23 | $7.53 | $7.53 |
- 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
- $8.36 / $8.81 / $12.30
| Professional | | $8.36 | $8.81 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.83 / $9.78 / $38.00
| Facility | | $7.83 | $9.78 | $38.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.75 / $13.63 / $17.04
| Professional | | $6.75 | $13.63 | $17.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.05 / $10.85 / $10.85
| Facility | | $5.05 | $10.85 | $10.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $7.23
| Professional | | $5.05 | $5.05 | $7.23 |