- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.31 / $33.60 / $67.03
| Facility | | $15.31 | $33.60 | $67.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.26 / $15.01 / $108.02
| Professional | | $11.26 | $15.01 | $108.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.67 / $11.67 / $11.67
| Professional | | $11.67 | $11.67 | $11.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.40 / $36.97 / $61.50
| Facility | | $9.40 | $36.97 | $61.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.73 / $14.15 / $20.17
| Professional | | $9.73 | $14.15 | $20.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.76 / $27.30 / $49.14
| Facility | | $11.76 | $27.30 | $49.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.31 / $20.65 / $25.81
| Professional | | $11.31 | $20.65 | $25.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.60 / $15.23 / $106.93
| Facility | | $12.60 | $15.23 | $106.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.06 / $9.86 / $13.72
| Professional | | $7.06 | $9.86 | $13.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.06 / $9.86 / $13.44
| Professional | | $7.06 | $9.86 | $13.44 |