- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.74 / $56.32 / $92.02
| Facility | | $31.74 | $56.32 | $92.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.86 / $16.35 / $26.68
| Professional | | $12.86 | $16.35 | $26.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.34 / $14.49 / $53.34
| Facility | | $13.34 | $14.49 | $53.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.36 / $15.69 / $19.62
| Professional | | $8.36 | $15.69 | $19.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.86 / $23.86 / $28.28
| Facility | | $12.86 | $23.86 | $28.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.68 / $13.68 / $16.42
| Professional | | $13.68 | $13.68 | $16.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.68 / $13.68 / $13.68
| Professional | | $13.68 | $13.68 | $13.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.52 / $30.78 / $50.34
| Facility | | $20.52 | $30.78 | $50.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.63 / $23.28 / $24.01
| Professional | | $11.63 | $23.28 | $24.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $8.13 / $22.51
| Professional | | $5.75 | $8.13 | $22.51 |