- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.74 / $27.35 / $110.06
| Facility | | $12.74 | $27.35 | $110.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.82 / $10.48 / $20.60
| Professional | | $9.82 | $10.48 | $20.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.76 / $36.76 / $54.46
| Facility | | $32.76 | $36.76 | $54.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.54 / $19.54 / $38.20
| Professional | | $19.54 | $19.54 | $38.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.61 / $14.87 / $64.20
| Facility | | $7.61 | $14.87 | $64.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $16.52 / $41.00
| Professional | | $7.15 | $16.52 | $41.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.57 / $12.53 / $25.06
| Facility | | $11.57 | $12.53 | $25.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.86 / $8.53 / $23.62
| Professional | | $4.86 | $8.53 | $23.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.79 / $11.58 / $14.48
| Facility | | $5.79 | $11.58 | $14.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.86 / $6.95 / $24.10
| Professional | | $4.86 | $6.95 | $24.10 |