- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.32 / $25.55 / $83.32
| Facility | | $16.32 | $25.55 | $83.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.50 / $16.28 / $17.53
| Professional | | $15.50 | $16.28 | $17.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.03 / $20.42 / $53.83
| Facility | | $13.03 | $20.42 | $53.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.52 / $21.35 / $32.01
| Professional | | $12.52 | $21.35 | $32.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.74 / $112.85 / $172.68
| Facility | | $57.74 | $112.85 | $172.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.56 / $13.05 / $26.31
| Professional | | $12.56 | $13.05 | $26.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.50 / $10.05 / $13.81
| Professional | | $2.50 | $10.05 | $13.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.41 / $31.41 / $31.41
| Facility | | $31.41 | $31.41 | $31.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.38 / $11.33 / $28.19
| Professional | | $8.38 | $11.33 | $28.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.85 / $12.56 / $12.56
| Professional | | $10.85 | $12.56 | $12.56 |