- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.66 / $30.01 / $121.80
| Facility | | $15.66 | $30.01 | $121.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.84 / $15.11 / $72.65
| Professional | | $10.84 | $15.11 | $72.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.03 / $19.75 / $57.68
| Facility | | $12.03 | $19.75 | $57.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.17 / $8.23 / $29.70
| Professional | | $6.17 | $8.23 | $29.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.37 / $16.67 / $26.67
| Facility | | $11.37 | $16.67 | $26.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.87 / $36.67 / $52.29
| Facility | | $14.87 | $36.67 | $52.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.24 / $20.23 / $25.30
| Professional | | $10.24 | $20.23 | $25.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.22 / $21.67 / $51.15
| Professional | | $18.22 | $21.67 | $51.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.50 / $11.65 / $30.46
| Professional | | $7.50 | $11.65 | $30.46 |