- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.88 / $25.53 / $106.34
| Facility | | $11.88 | $25.53 | $106.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.29 / $13.00 / $16.05
| Professional | | $11.29 | $13.00 | $16.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.30 / $7.30 / $10.13
| Professional | | $7.30 | $7.30 | $10.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.74 / $31.89 / $46.21
| Facility | | $23.74 | $31.89 | $46.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.86 / $13.86 / $21.43
| Professional | | $13.86 | $13.86 | $21.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.48 / $10.19 / $23.81
| Facility | | $9.48 | $10.19 | $23.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.48 / $14.58 / $21.17
| Professional | | $6.48 | $14.58 | $21.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.71 / $12.71 / $69.56
| Facility | | $12.71 | $12.71 | $69.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.13 / $8.40 / $18.23
| Professional | | $6.13 | $8.40 | $18.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.13 / $8.02 / $9.48
| Professional | | $6.13 | $8.02 | $9.48 |