- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.71 / $100.20 / $254.01
| Facility | | $12.71 | $100.20 | $254.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.73 / $11.28 / $12.71
| Professional | | $6.73 | $11.28 | $12.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.31 / $9.31 / $9.31
| Facility | | $9.31 | $9.31 | $9.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.26 / $13.62 / $13.62
| Professional | | $9.26 | $13.62 | $13.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.58 / $8.58 / $8.58
| Facility | | $8.58 | $8.58 | $8.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.31 / $5.31 / $8.17
| Professional | | $5.31 | $5.31 | $8.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.16 / $10.08 / $20.74
| Facility | | $6.16 | $10.08 | $20.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.86 / $9.50 / $11.87
| Professional | | $4.86 | $9.50 | $11.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.31 / $5.31 / $10.21
| Facility | | $5.31 | $5.31 | $10.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.43 / $4.90 / $15.53
| Professional | | $3.43 | $4.90 | $15.53 |