- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.64 / $20.11 / $38.70
| Professional | | $19.64 | $20.11 | $38.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.63 / $46.46 / $48.15
| Professional | | $41.63 | $46.46 | $48.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.86 / $31.72 / $75.69
| Professional | | $12.86 | $31.72 | $75.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.93 / $20.01 / $36.71
| Facility | | $11.93 | $20.01 | $36.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.87 / $30.23 / $46.08
| Professional | | $26.87 | $30.23 | $46.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.07 / $23.71 / $39.54
| Professional | | $17.07 | $23.71 | $39.54 |