- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.25 / $19.10 / $24.78
| Facility | | $14.25 | $19.10 | $24.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.73 / $14.25 / $22.46
| Professional | | $10.73 | $14.25 | $22.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.26 / $8.60 / $8.60
| Professional | | $8.26 | $8.60 | $8.60 |
- 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
- $8.61 / $9.06 / $12.65
| Professional | | $8.61 | $9.06 | $12.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.69 / $13.04 / $39.02
| Facility | | $9.69 | $13.04 | $39.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.49 / $9.52 / $17.55
| Professional | | $6.49 | $9.52 | $17.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.20 / $5.20 / $10.11
| Professional | | $5.20 | $5.20 | $10.11 |