- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.47 / $15.07 / $48.80
| Professional | | $11.47 | $15.07 | $48.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.14 / $19.78 / $27.89
| Professional | | $17.14 | $19.78 | $27.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.31 / $20.05 / $41.05
| Professional | | $12.31 | $20.05 | $41.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.05 / $13.79 / $26.98
| Professional | | $11.05 | $13.79 | $26.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.81 / $17.86 / $28.26
| Professional | | $12.81 | $17.86 | $28.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.28 / $13.49 / $17.23
| Professional | | $12.28 | $13.49 | $17.23 |