- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.76 / $31.25 / $78.39
| Facility | | $16.76 | $31.25 | $78.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.07 / $13.66 / $27.34
| Professional | | $13.07 | $13.66 | $27.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.06 / $10.06 / $10.06
| Professional | | $10.06 | $10.06 | $10.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.46 / $16.76 / $20.95
| Facility | | $7.46 | $16.76 | $20.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.44 / $10.22 / $12.30
| Professional | | $7.44 | $10.22 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.89 / $19.60 / $60.66
| Facility | | $10.89 | $19.60 | $60.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.59 / $19.41 / $24.26
| Professional | | $11.59 | $19.41 | $24.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.21 / $16.76 / $17.60
| Professional | | $0.21 | $16.76 | $17.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.18 / $5.18 / $5.18
| Professional | | $5.18 | $5.18 | $5.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.06 / $12.64 / $19.95
| Professional | | $10.06 | $12.64 | $19.95 |