- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.60 / $23.24 / $30.39
| Facility | | $20.60 | $23.24 | $30.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.55 / $20.60 / $22.68
| Professional | | $18.55 | $20.60 | $22.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.03 / $23.03 / $23.03
| Facility | | $23.03 | $23.03 | $23.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.18 / $32.18 / $32.18
| Facility | | $32.18 | $32.18 | $32.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.94 / $24.85 / $56.62
| Professional | | $18.94 | $24.85 | $56.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.86 / $27.35 / $47.91
| Professional | | $17.86 | $27.35 | $47.91 |