- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.10 / $39.06 / $173.86
| Facility | | $10.10 | $39.06 | $173.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.38 / $11.72 / $23.06
| Professional | | $8.38 | $11.72 | $23.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.09 / $14.54 / $43.60
| Facility | | $9.09 | $14.54 | $43.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.03 / $8.08 / $21.22
| Professional | | $4.03 | $8.08 | $21.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.02 / $12.60 / $20.16
| Facility | | $7.02 | $12.60 | $20.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.19 / $8.19 / $12.60
| Professional | | $8.19 | $8.19 | $12.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.58 / $27.72 / $38.68
| Facility | | $12.58 | $27.72 | $38.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.67 / $15.28 / $19.10
| Professional | | $5.67 | $15.28 | $19.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.77 / $14.49 / $18.98
| Professional | | $13.77 | $14.49 | $18.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.02 / $8.19 / $15.75
| Professional | | $6.02 | $8.19 | $15.75 |