- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.10 / $70.05 / $100.37
| Facility | | $22.10 | $70.05 | $100.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.54 / $19.37 / $23.24
| Professional | | $14.54 | $19.37 | $23.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.07 / $15.07 / $16.62
| Professional | | $15.07 | $15.07 | $16.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.78 / $61.94 / $103.21
| Facility | | $15.78 | $61.94 | $103.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.85 / $23.76 / $33.86
| Professional | | $14.85 | $23.76 | $33.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.19 / $35.28 / $63.50
| Facility | | $15.19 | $35.28 | $63.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.64 / $26.43 / $33.04
| Professional | | $14.64 | $26.43 | $33.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.28 / $19.66 / $122.00
| Facility | | $16.28 | $19.66 | $122.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.11 / $12.73 / $19.57
| Professional | | $9.11 | $12.73 | $19.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.11 / $12.73 / $16.80
| Professional | | $9.11 | $12.73 | $16.80 |