- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.36 / $55.10 / $132.05
| Facility | | $9.36 | $55.10 | $132.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.44 / $5.83 / $40.04
| Professional | | $5.44 | $5.83 | $40.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.06 / $13.06 / $13.06
| Facility | | $13.06 | $13.06 | $13.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.43 / $11.75 / $14.69
| Professional | | $7.43 | $11.75 | $14.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.21 / $15.37 / $108.19
| Facility | | $6.21 | $15.37 | $108.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.89 / $4.53 / $9.06
| Professional | | $3.89 | $4.53 | $9.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.36 / $13.19 / $20.30
| Facility | | $8.36 | $13.19 | $20.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.36 / $14.21 / $18.55
| Professional | | $8.36 | $14.21 | $18.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.58 / $15.13 / $17.80
| Professional | | $10.58 | $15.13 | $17.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.72 / $5.83 / $13.34
| Professional | | $2.72 | $5.83 | $13.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.48 / $6.48 / $6.48
| Professional | | $6.48 | $6.48 | $6.48 |