- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.03 / $37.36 / $74.53
| Facility | | $17.03 | $37.36 | $74.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.52 / $16.93 / $120.11
| Professional | | $12.52 | $16.93 | $120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.45 / $41.02 / $68.36
| Facility | | $10.45 | $41.02 | $68.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.82 / $15.74 / $22.42
| Professional | | $10.82 | $15.74 | $22.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.07 / $30.35 / $54.63
| Facility | | $13.07 | $30.35 | $54.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.64 / $22.72 / $28.40
| Professional | | $12.64 | $22.72 | $28.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.01 / $16.95 / $155.00
| Facility | | $14.01 | $16.95 | $155.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.85 / $10.97 / $25.69
| Professional | | $7.85 | $10.97 | $25.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.85 / $10.97 / $15.26
| Professional | | $7.85 | $10.97 | $15.26 |