- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.01 / $66.65 / $128.65
| Facility | | $17.01 | $66.65 | $128.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.32 / $16.39 / $31.60
| Professional | | $12.32 | $16.39 | $31.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.19 / $12.78 / $12.87
| Professional | | $9.19 | $12.78 | $12.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.29 / $38.40 / $67.31
| Facility | | $10.29 | $38.40 | $67.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.65 / $15.50 / $22.08
| Professional | | $10.65 | $15.50 | $22.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.86 / $29.88 / $53.78
| Facility | | $12.86 | $29.88 | $53.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.31 / $21.06 / $27.88
| Professional | | $12.31 | $21.06 | $27.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.71 / $16.03 / $87.35
| Facility | | $14.71 | $16.03 | $87.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.72 / $10.79 / $16.94
| Professional | | $7.72 | $10.79 | $16.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.72 / $10.79 / $14.71
| Professional | | $7.72 | $10.79 | $14.71 |