- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $12.30 / $14.45
| Facility | | $10.96 | $12.30 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $15.14 / $52.48
| Professional | | $10.00 | $15.14 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $21.38 / $25.12 / $44.67
| Professional | 25 | $21.38 | $25.12 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $14.45 / $16.98
| Professional | | $11.48 | $14.45 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.23 / $13.80 / $50.12
| Facility | | $10.23 | $13.80 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $14.13 / $21.88
| Professional | | $10.47 | $14.13 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $17.78 / $30.90
| Professional | | $13.49 | $17.78 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.23 / $13.18 / $22.39
| Facility | | $10.23 | $13.18 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.18 / $20.42 / $93.33
| Professional | | $13.18 | $20.42 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $16.22 / $16.22 / $16.22
| Professional | 25 | $16.22 | $16.22 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $11.22 / $13.49
| Facility | | $9.55 | $11.22 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.75 / $15.49 / $26.92
| Professional | | $11.75 | $15.49 | $26.92 |