- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.50 / $12.26 / $19.35
| Facility | | $11.50 | $12.26 | $19.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.71 / $12.26 / $25.80
| Professional | | $10.71 | $12.26 | $25.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.55 / $14.60 / $25.64
| Facility | | $10.55 | $14.60 | $25.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.58 / $9.68 / $13.07
| Professional | | $6.58 | $9.68 | $13.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.92 / $14.87 / $18.59
| Professional | | $9.92 | $14.87 | $18.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.65 / $12.26 / $22.53
| Facility | | $11.65 | $12.26 | $22.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.61 / $15.48 / $19.67
| Professional | | $11.61 | $15.48 | $19.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.61 / $10.68 / $14.41
| Professional | | $9.61 | $10.68 | $14.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.45 / $12.90 / $12.90
| Facility | | $6.45 | $12.90 | $12.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.42 / $10.56 / $16.77
| Professional | | $5.42 | $10.56 | $16.77 |