- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.80 / $55.21 / $236.57
| Facility | | $9.80 | $55.21 | $236.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.18 / $11.08 / $11.24
| Professional | | $10.18 | $11.08 | $11.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.51 / $15.51 / $15.51
| Professional | | $15.51 | $15.51 | $15.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.73 / $11.17 / $13.04
| Facility | | $7.73 | $11.17 | $13.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.87 / $6.13 / $12.29
| Professional | | $5.87 | $6.13 | $12.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.41 / $14.89 / $17.37
| Facility | | $12.41 | $14.89 | $17.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.41 / $15.02 / $24.82
| Professional | | $12.41 | $15.02 | $24.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.07 / $9.66 / $22.50
| Facility | | $8.07 | $9.66 | $22.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.27 / $14.04 / $80.78
| Professional | | $6.27 | $14.04 | $80.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.83 / $6.83 / $6.83
| Professional | | $6.83 | $6.83 | $6.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.21 / $10.40 / $17.34
| Professional | | $5.21 | $10.40 | $17.34 |