- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.32 / $23.24 / $30.16
| Facility | | $17.32 | $23.24 | $30.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.56 / $13.05 / $17.34
| Professional | | $10.56 | $13.05 | $17.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.05 / $10.47 / $10.47
| Professional | | $10.05 | $10.47 | $10.47 |
- 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
- $10.46 / $11.01 / $15.38
| Professional | | $10.46 | $11.01 | $15.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.78 / $15.88 / $47.24
| Facility | | $11.78 | $15.88 | $47.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.85 / $11.59 / $21.68
| Professional | | $7.85 | $11.59 | $21.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.57 / $15.08 / $18.46
| Facility | | $13.57 | $15.08 | $18.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.33 / $8.85 / $21.06
| Professional | | $6.33 | $8.85 | $21.06 |