- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.02 / $25.04 / $38.58
| Facility | | $10.02 | $25.04 | $38.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.02 / $10.02 / $17.94
| Professional | | $10.02 | $10.02 | $17.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.06 / $13.77 / $22.16
| Facility | | $11.06 | $13.77 | $22.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.18 / $6.18 / $13.52
| Professional | | $6.18 | $6.18 | $13.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.53 / $12.52 / $16.89
| Facility | | $8.53 | $12.52 | $16.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.64 / $16.28 / $16.89
| Professional | | $10.64 | $16.28 | $16.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.14 / $12.89 / $47.51
| Facility | | $8.14 | $12.89 | $47.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.44 / $10.05 / $18.23
| Professional | | $6.44 | $10.05 | $18.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.14 / $12.89 / $48.59
| Facility | | $8.14 | $12.89 | $48.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.47 / $8.14 / $16.79
| Professional | | $5.47 | $8.14 | $16.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.39 / $10.32 / $15.02
| Professional | | $9.39 | $10.32 | $15.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.26 / $9.27 / $16.54
| Professional | | $5.26 | $9.27 | $16.54 |