- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.58 / $59.82 / $79.48
| Facility | | $25.58 | $59.82 | $79.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.09 / $15.63 / $116.06
| Professional | | $12.09 | $15.63 | $116.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.73 / $11.73 / $11.73
| Professional | | $11.73 | $11.73 | $11.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.10 / $39.72 / $66.05
| Facility | | $10.10 | $39.72 | $66.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.46 / $15.21 / $21.67
| Professional | | $10.46 | $15.21 | $21.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.64 / $29.33 / $52.79
| Facility | | $12.64 | $29.33 | $52.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.15 / $21.89 / $27.36
| Professional | | $12.15 | $21.89 | $27.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.54 / $15.74 / $137.69
| Facility | | $13.54 | $15.74 | $137.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.58 / $10.60 / $14.44
| Professional | | $7.58 | $10.60 | $14.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.58 / $10.60 / $11.07
| Professional | | $7.58 | $10.60 | $11.07 |