- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $19.27 / $62.85
| Facility | | $5.25 | $19.27 | $62.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.41 / $13.57 / $16.76
| Professional | | $12.41 | $13.57 | $16.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.06 / $10.06 / $10.48
| Professional | | $10.06 | $10.06 | $10.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.44 / $16.16 / $49.17
| Facility | | $10.44 | $16.16 | $49.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.03 / $17.43 / $24.26
| Professional | | $10.03 | $17.43 | $24.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.00 / $85.72 / $138.18
| Facility | | $15.00 | $85.72 | $138.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.26 / $20.88 / $24.81
| Professional | | $8.26 | $20.88 | $24.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $8.05 / $11.06
| Professional | | $2.00 | $8.05 | $11.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.76 / $16.76 / $25.14
| Facility | | $16.76 | $16.76 | $25.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.54 / $12.41 / $22.56
| Professional | | $7.54 | $12.41 | $22.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.68 / $10.06 / $10.06
| Professional | | $8.68 | $10.06 | $10.06 |