- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.77 / $25.55 / $51.09
| Facility | | $12.77 | $25.55 | $51.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.77 / $20.44 / $109.50
| Professional | | $12.77 | $20.44 | $109.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.66 / $112.83 / $183.19
| Facility | | $30.66 | $112.83 | $183.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.45 / $13.93 / $16.38
| Professional | | $10.45 | $13.93 | $16.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.07 / $11.07 / $11.07
| Facility | | $11.07 | $11.07 | $11.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.72 / $20.52 / $48.25
| Professional | | $8.72 | $20.52 | $48.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $9.36 / $9.36
| Professional | | $9.36 | $9.36 | $9.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.18 / $21.54 / $33.32
| Facility | | $16.18 | $21.54 | $33.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.72 / $17.03 / $48.25
| Professional | | $8.72 | $17.03 | $48.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $10.07 / $10.45
| Professional | | $7.15 | $10.07 | $10.45 |