- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.08 / $31.55 / $40.77
| Facility | | $28.08 | $31.55 | $40.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.73 / $27.88 / $46.32
| Professional | | $20.73 | $27.88 | $46.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.32 / $38.32 / $38.32
| Professional | | $38.32 | $38.32 | $38.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.01 / $33.34 / $38.84
| Professional | | $25.01 | $33.34 | $38.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.60 / $32.14 / $38.94
| Facility | | $23.60 | $32.14 | $38.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $35.02 / $63.47
| Professional | | $26.30 | $35.02 | $63.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.46 / $34.46 / $34.46
| Facility | | $34.46 | $34.46 | $34.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.15 / $34.40 / $45.73
| Professional | | $27.15 | $34.40 | $45.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.07 / $44.07 / $44.07
| Professional | | $44.07 | $44.07 | $44.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $32.28 / $41.58
| Professional | | $26.30 | $32.28 | $41.58 |