- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.40 / $16.32 / $40.78
| Facility | | $11.40 | $16.32 | $40.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.81 / $21.46
| Professional | | $10.47 | $10.81 | $21.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.00 / $17.61 / $33.47
| Facility | | $12.00 | $17.61 | $33.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.92 / $7.20 / $19.12
| Professional | | $5.92 | $7.20 | $19.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.89 / $15.53 / $44.21
| Facility | | $7.89 | $15.53 | $44.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.06 / $13.63 / $17.04
| Professional | | $9.06 | $13.63 | $17.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.52 / $9.60 / $14.82
| Professional | | $5.52 | $9.60 | $14.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $12.00 / $21.06
| Professional | | $5.25 | $12.00 | $21.06 |