- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.81 / $26.62 / $86.27
| Facility | | $10.81 | $26.62 | $86.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.28 / $10.33 / $20.82
| Professional | | $9.28 | $10.33 | $20.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.47 / $14.65 / $39.69
| Facility | | $11.47 | $14.65 | $39.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.67 / $5.67 / $12.82
| Professional | | $5.67 | $5.67 | $12.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.02 / $18.39 / $38.22
| Facility | | $8.02 | $18.39 | $38.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.31 / $13.22 / $16.70
| Professional | | $7.31 | $13.22 | $16.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.32 / $11.47 / $13.76
| Facility | | $10.32 | $11.47 | $13.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.82 / $6.88 / $16.03
| Professional | | $4.82 | $6.88 | $16.03 |