- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.14 / $12.15 / $15.07
| Professional | | $10.14 | $12.15 | $15.07 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $21.00 / $24.55 / $26.40
| Professional | 25 | $21.00 | $24.55 | $26.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.98 / $13.56 / $18.07
| Professional | | $10.98 | $13.56 | $18.07 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $12.82 / $13.56 / $17.43
| Professional | 25 | $12.82 | $13.56 | $17.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.96 / $34.82 / $37.83
| Facility | | $29.96 | $34.82 | $37.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.42 / $15.29 / $18.46
| Professional | | $11.42 | $15.29 | $18.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.33 / $14.68 / $29.53
| Professional | | $10.33 | $14.68 | $29.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.32 / $13.03 / $19.16
| Professional | | $10.32 | $13.03 | $19.16 |