- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.31 / $34.35 / $40.42
| Facility | | $30.31 | $34.35 | $40.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.17 / $35.74 / $47.65
| Professional | | $28.17 | $35.74 | $47.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.08 / $39.51 / $62.14
| Professional | | $29.08 | $39.51 | $62.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.00 / $39.00 / $51.05
| Professional | | $26.00 | $39.00 | $51.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.22 / $40.88 / $57.77
| Facility | | $34.22 | $40.88 | $57.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.35 / $45.96 / $71.76
| Professional | | $35.35 | $45.96 | $71.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.22 / $43.87 / $72.22
| Professional | | $34.22 | $43.87 | $72.22 |