- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.13 / $14.31 / $76.78
| Facility | | $4.13 | $14.31 | $76.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.89 / $14.17 / $15.14
| Professional | | $10.89 | $14.17 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.75 / $9.76 / $9.76
| Professional | | $9.75 | $9.76 | $9.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.01 / $17.48 / $41.80
| Facility | | $11.01 | $17.48 | $41.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.87 / $18.54 / $24.78
| Professional | | $10.87 | $18.54 | $24.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.18 / $92.46 / $149.03
| Facility | | $16.18 | $92.46 | $149.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.76 / $11.26 / $22.72
| Professional | | $9.76 | $11.26 | $22.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $8.43 / $11.59
| Professional | | $2.11 | $8.43 | $11.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $9.61 / $22.72
| Professional | | $6.50 | $9.61 | $22.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.42 / $10.54 / $10.54
| Professional | | $8.42 | $10.54 | $10.54 |