- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.16 / $12.70 / $20.54
| Facility | | $10.16 | $12.70 | $20.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.26 / $10.27 / $12.70
| Professional | | $10.26 | $10.27 | $12.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.69 / $14.28 / $20.56
| Facility | | $9.69 | $14.28 | $20.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.27 / $10.27 / $11.14
| Professional | | $10.27 | $10.27 | $11.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.89 / $22.02 / $26.38
| Professional | | $9.89 | $22.02 | $26.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.27 / $14.69 / $32.27
| Facility | | $10.27 | $14.69 | $32.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.27 / $11.30 / $13.35
| Professional | | $10.27 | $11.30 | $13.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.16 / $11.82 / $30.48
| Facility | | $10.16 | $11.82 | $30.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.27 / $14.69 / $25.50
| Facility | | $10.27 | $14.69 | $25.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.27 / $12.60 / $12.95
| Professional | | $10.27 | $12.60 | $12.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.30 / $33.06 / $38.88
| Facility | | $16.30 | $33.06 | $38.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.27 / $10.27 / $10.27
| Professional | | $10.27 | $10.27 | $10.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.27 / $10.27 / $11.81
| Professional | | $10.27 | $10.27 | $11.81 |