- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.38 / $14.56 / $46.71
| Facility | | $10.38 | $14.56 | $46.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.52 / $10.38 / $12.03
| Professional | | $7.52 | $10.38 | $12.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $11.39 / $37.97
| Facility | | $10.00 | $11.39 | $37.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.22 / $5.46 / $8.73
| Professional | | $5.22 | $5.46 | $8.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.66 / $15.19 / $17.09
| Facility | | $12.66 | $15.19 | $17.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.66 / $14.56 / $17.95
| Professional | | $12.66 | $14.56 | $17.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.23 / $12.66 / $29.34
| Facility | | $8.23 | $12.66 | $29.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.27 / $14.46 / $27.74
| Professional | | $7.27 | $14.46 | $27.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.66 / $12.66 / $12.66
| Facility | | $12.66 | $12.66 | $12.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.32 / $7.60 / $12.28
| Professional | | $5.32 | $7.60 | $12.28 |