- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.40 / $32.40 / $37.26
| Facility | | $32.40 | $32.40 | $37.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.14 / $32.47 / $40.18
| Professional | | $32.14 | $32.47 | $40.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.33 / $30.33 / $32.15
| Facility | | $30.33 | $30.33 | $32.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.15 / $32.15 / $32.15
| Professional | | $32.15 | $32.15 | $32.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.40 / $40.18 / $51.43
| Facility | | $32.40 | $40.18 | $51.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.15 / $34.08 / $40.19
| Professional | | $32.15 | $34.08 | $40.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.54 / $32.38 / $63.14
| Professional | | $24.54 | $32.38 | $63.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.15 / $32.15 / $61.17
| Facility | | $32.15 | $32.15 | $61.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.36 / $38.58 / $38.58
| Professional | | $35.36 | $38.58 | $38.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.15 / $32.15 / $45.01
| Professional | | $32.15 | $32.15 | $45.01 |