- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.97 / $60.45 / $202.50
| Facility | | $15.97 | $60.45 | $202.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.29 / $12.48 / $47.00
| Professional | | $11.29 | $12.48 | $47.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.92 / $9.92 / $11.23
| Professional | | $9.92 | $9.92 | $11.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.66 / $36.08 / $63.23
| Facility | | $9.66 | $36.08 | $63.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $14.55 / $20.74
| Professional | | $10.00 | $14.55 | $20.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.92 / $28.08 / $50.54
| Facility | | $10.92 | $28.08 | $50.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.65 / $19.82 / $26.33
| Professional | | $8.65 | $19.82 | $26.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.58 / $12.73 / $123.64
| Facility | | $12.58 | $12.73 | $123.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $7.60 / $13.17
| Professional | | $7.25 | $7.60 | $13.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $7.60 / $10.57
| Professional | | $7.25 | $7.60 | $10.57 |