- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.46 / $15.79 / $16.68
| Facility | | $14.46 | $15.79 | $16.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $14.48 / $21.11
| Professional | | $10.47 | $14.48 | $21.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.73 / $10.73 / $24.58
| Facility | | $10.73 | $10.73 | $24.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.73 / $10.73 / $19.65
| Professional | | $10.73 | $10.73 | $19.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.09 / $15.15 / $15.15
| Facility | | $12.09 | $15.15 | $15.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $12.88 / $17.82
| Professional | | $12.88 | $12.88 | $17.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.36 / $11.58 / $17.84
| Professional | | $8.36 | $11.58 | $17.84 |