- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.12 / $63.10 / $91.20
| Facility | | $25.12 | $63.10 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $15.85 / $112.20
| Professional | | $12.88 | $15.85 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $12.30 / $12.59
| Professional | | $11.48 | $12.30 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $30.20 / $44.67
| Facility | | $9.33 | $30.20 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $14.13 / $28.18
| Professional | | $10.72 | $14.13 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $17.38 / $57.54
| Facility | | $12.59 | $17.38 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.62 / $21.88 / $44.67
| Professional | | $18.62 | $21.88 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $16.98 / $158.49
| Facility | | $14.45 | $16.98 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $10.47 / $16.22
| Professional | | $7.41 | $10.47 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $17.78 / $21.38
| Facility | | $10.72 | $17.78 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $10.23 / $10.72
| Professional | | $7.41 | $10.23 | $10.72 |