- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.08 / $58.06 / $76.12
| Facility | | $11.08 | $58.06 | $76.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.08 / $14.25 / $18.32
| Professional | | $11.08 | $14.25 | $18.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.97 / $14.36 / $45.02
| Facility | | $13.97 | $14.36 | $45.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.28 / $19.00 / $23.75
| Professional | | $10.28 | $19.00 | $23.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.34 / $18.79 / $73.51
| Facility | | $16.34 | $18.79 | $73.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.51 / $13.29 / $18.75
| Professional | | $12.51 | $13.29 | $18.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.86 / $9.35 / $9.80
| Professional | | $6.86 | $9.35 | $9.80 |