- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.58 / $36.33 / $125.47
| Facility | | $10.58 | $36.33 | $125.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.34 / $11.62 / $12.92
| Professional | | $10.34 | $11.62 | $12.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.03 / $11.63 / $13.58
| Facility | | $8.03 | $11.63 | $13.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.38 / $6.38 / $12.80
| Professional | | $6.38 | $6.38 | $12.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.92 / $15.50 / $18.16
| Facility | | $12.92 | $15.50 | $18.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.92 / $15.63 / $25.84
| Professional | | $12.92 | $15.63 | $25.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.40 / $10.05 / $23.42
| Facility | | $8.40 | $10.05 | $23.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.60 / $14.87 / $84.46
| Professional | | $6.60 | $14.87 | $84.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.11 / $7.11 / $7.11
| Professional | | $7.11 | $7.11 | $7.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.43 / $10.82 / $18.04
| Professional | | $5.43 | $10.82 | $18.04 |