- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.17 / $19.25 / $33.22
| Facility | | $12.17 | $19.25 | $33.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.17 / $12.46 / $13.89
| Professional | | $12.17 | $12.46 | $13.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.32 / $15.04 / $66.09
| Facility | | $14.32 | $15.04 | $66.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.07 / $11.81 / $38.53
| Professional | | $7.07 | $11.81 | $38.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.82 / $30.04 / $80.25
| Facility | | $18.82 | $30.04 | $80.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.36 / $14.40 / $21.29
| Professional | | $8.36 | $14.40 | $21.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.89 / $23.00 / $100.00
| Facility | | $12.89 | $23.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.01 / $10.61 / $17.98
| Professional | | $6.01 | $10.61 | $17.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.68 / $20.01 / $21.48
| Facility | | $17.68 | $20.01 | $21.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.01 / $10.61 / $23.63
| Professional | | $6.01 | $10.61 | $23.63 |