- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.91 / $19.45 / $33.82
| Facility | | $16.91 | $19.45 | $33.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.52 / $15.34 / $30.28
| Professional | | $14.52 | $15.34 | $30.28 |
- 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
- $11.74 / $12.36 / $17.26
| Professional | | $11.74 | $12.36 | $17.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.22 / $17.80 / $53.40
| Facility | | $13.22 | $17.80 | $53.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.88 / $13.00 / $24.26
| Professional | | $8.88 | $13.00 | $24.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.10 / $8.46 / $23.62
| Professional | | $7.10 | $8.46 | $23.62 |