- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.03 / $11.03 / $22.06
| Facility | | $11.03 | $11.03 | $22.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.02 / $11.03 / $15.14
| Professional | | $11.02 | $11.03 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.02 / $10.93 / $16.39
| Facility | | $6.02 | $10.93 | $16.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.02 / $10.25 / $11.03
| Professional | | $6.02 | $10.25 | $11.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.61 / $35.47 / $43.19
| Facility | | $20.61 | $35.47 | $43.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.25 / $13.39 / $14.14
| Professional | | $11.25 | $13.39 | $14.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $32.36 / $40.63
| Facility | | $17.78 | $32.36 | $40.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.14 / $11.14 / $15.59
| Professional | | $11.14 | $11.14 | $15.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.48 / $10.93 / $18.64
| Facility | | $6.48 | $10.93 | $18.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.71 / $10.85 / $13.09
| Professional | | $10.71 | $10.85 | $13.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.35 / $10.85 / $13.09
| Professional | | $10.35 | $10.85 | $13.09 |