- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.43 / $37.22 / $74.55
| Facility | | $25.43 | $37.22 | $74.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.46 / $27.92 / $33.22
| Professional | | $13.46 | $27.92 | $33.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.97 / $15.18 / $55.86
| Facility | | $13.97 | $15.18 | $55.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.91 / $16.52 / $20.65
| Professional | | $7.91 | $16.52 | $20.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.46 / $24.22 / $30.40
| Facility | | $13.46 | $24.22 | $30.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.32 / $14.32 / $17.18
| Professional | | $14.32 | $14.32 | $17.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.32 / $14.32 / $14.32
| Professional | | $14.32 | $14.32 | $14.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.48 / $32.22 / $52.70
| Facility | | $21.48 | $32.22 | $52.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.17 / $24.44 / $25.18
| Professional | | $12.17 | $24.44 | $25.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.01 / $7.70 / $21.31
| Professional | | $6.01 | $7.70 | $21.31 |