- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.48 / $61.69 / $124.73
| Facility | | $20.48 | $61.69 | $124.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.06 / $20.03 / $144.55
| Professional | | $15.06 | $20.03 | $144.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.58 / $49.47 / $82.28
| Facility | | $12.58 | $49.47 | $82.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.02 / $18.94 / $26.98
| Professional | | $13.02 | $18.94 | $26.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.89 / $36.53 / $65.75
| Facility | | $13.89 | $36.53 | $65.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.15 / $25.61 / $34.08
| Professional | | $11.15 | $25.61 | $34.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.24 / $15.06 / $106.78
| Facility | | $11.24 | $15.06 | $106.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $14.15 / $22.48
| Professional | | $13.49 | $14.15 | $22.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.23 / $21.22 / $26.98
| Facility | | $20.23 | $21.22 | $26.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $14.04 / $22.48
| Professional | | $13.49 | $14.04 | $22.48 |