- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.07 / $43.48 / $138.38
| Facility | | $20.07 | $43.48 | $138.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.16 / $17.66 / $18.27
| Professional | | $16.16 | $17.66 | $18.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.78 / $11.78 / $11.78
| Professional | | $11.78 | $11.78 | $11.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.29 / $21.08 / $50.47
| Facility | | $13.29 | $21.08 | $50.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.01 / $16.03 / $29.94
| Professional | | $13.01 | $16.03 | $29.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.53 / $20.30 / $20.30
| Facility | | $19.53 | $20.30 | $20.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.78 / $13.74 / $27.48
| Professional | | $11.78 | $13.74 | $27.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.36 / $9.42 / $12.95
| Professional | | $2.36 | $9.42 | $12.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.63 / $19.63 / $29.44
| Facility | | $19.63 | $19.63 | $29.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.87 / $11.52 / $27.42
| Professional | | $6.87 | $11.52 | $27.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.17 / $11.78 / $11.78
| Professional | | $10.17 | $11.78 | $11.78 |