- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.29 / $147.09 / $183.56
| Facility | | $19.29 | $147.09 | $183.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.08 / $14.63 / $20.12
| Professional | | $13.08 | $14.63 | $20.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.06 / $10.06 / $10.06
| Professional | | $10.06 | $10.06 | $10.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.47 / $16.77 / $20.96
| Facility | | $7.47 | $16.77 | $20.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.27 / $10.14 / $12.87
| Professional | | $8.27 | $10.14 | $12.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.90 / $19.62 / $60.71
| Facility | | $10.90 | $19.62 | $60.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.60 / $19.41 / $24.26
| Professional | | $12.60 | $19.41 | $24.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.14 / $16.77 / $17.61
| Professional | | $0.14 | $16.77 | $17.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $5.75 / $5.75
| Professional | | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.52 / $11.52 / $41.26
| Facility | | $11.52 | $11.52 | $41.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.04 / $9.84 / $16.77
| Professional | | $7.04 | $9.84 | $16.77 |