- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.67 / $34.71 / $44.48
| Facility | | $28.67 | $34.71 | $44.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.51 / $29.75 / $41.94
| Professional | | $21.51 | $29.75 | $41.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.34 / $32.11 / $43.44
| Professional | | $24.34 | $32.11 | $43.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.72 / $20.88 / $31.41
| Facility | | $20.72 | $20.88 | $31.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.65 / $33.26 / $77.95
| Professional | | $23.65 | $33.26 | $77.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.56 / $33.20 / $62.59
| Professional | | $26.56 | $33.20 | $62.59 |