- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.48 / $31.03 / $41.21
| Facility | | $17.48 | $31.03 | $41.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.01 / $16.70 / $21.48
| Professional | | $14.01 | $16.70 | $21.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.21 / $11.21 / $11.21
| Professional | | $11.21 | $11.21 | $11.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $18.68 / $23.35
| Facility | | $8.32 | $18.68 | $23.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.23 / $11.30 / $14.34
| Professional | | $9.23 | $11.30 | $14.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.14 / $21.85 / $67.62
| Facility | | $12.14 | $21.85 | $67.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.04 / $21.48 / $26.85
| Professional | | $14.04 | $21.48 | $26.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.23 / $18.68 / $19.61
| Professional | | $0.23 | $18.68 | $19.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.42 / $6.42 / $6.42
| Professional | | $6.42 | $6.42 | $6.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.02 / $28.02 / $28.02
| Facility | | $28.02 | $28.02 | $28.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.85 / $10.97 / $26.00
| Professional | | $7.85 | $10.97 | $26.00 |