- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.74 / $63.31 / $173.34
| Facility | | $13.74 | $63.31 | $173.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $13.15 / $26.10
| Professional | | $9.36 | $13.15 | $26.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.54 / $10.47 / $10.56
| Professional | | $7.54 | $10.47 | $10.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.43 / $30.02 / $52.54
| Facility | | $8.43 | $30.02 | $52.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.73 / $12.70 / $18.10
| Professional | | $8.73 | $12.70 | $18.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.54 / $24.50 / $44.10
| Facility | | $10.54 | $24.50 | $44.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.15 / $18.59 / $23.24
| Professional | | $10.15 | $18.59 | $23.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.06 / $13.14 / $100.00
| Facility | | $12.06 | $13.14 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.33 / $8.85 / $13.88
| Professional | | $6.33 | $8.85 | $13.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.33 / $8.85 / $9.24
| Professional | | $6.33 | $8.85 | $9.24 |