- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.46 / $36.11 / $72.06
| Facility | | $16.46 | $36.11 | $72.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.10 / $24.30 / $116.13
| Professional | | $12.10 | $24.30 | $116.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.10 / $39.75 / $66.11
| Facility | | $10.10 | $39.75 | $66.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.46 / $15.22 / $21.68
| Professional | | $10.46 | $15.22 | $21.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.57 / $29.35 / $52.83
| Facility | | $14.57 | $29.35 | $52.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.98 / $21.89 / $27.36
| Professional | | $13.98 | $21.89 | $27.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.31 / $19.54 / $106.00
| Facility | | $13.31 | $19.54 | $106.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $11.91 / $14.45
| Professional | | $7.59 | $11.91 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.25 / $21.67 / $26.16
| Facility | | $16.25 | $21.67 | $26.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $10.84 / $12.76
| Professional | | $7.59 | $10.84 | $12.76 |