- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $15.31 / $20.84
| Professional | | $12.05 | $15.31 | $20.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.36 / $12.88 / $15.45
| Professional | | $12.36 | $12.88 | $15.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $13.67 / $18.45
| Professional | | $10.30 | $13.67 | $18.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $12.36 / $15.21
| Professional | | $10.30 | $12.36 | $15.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.41 / $18.52 / $28.09
| Professional | | $12.41 | $18.52 | $28.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.54 / $16.32 / $27.58
| Professional | | $12.54 | $16.32 | $27.58 |