- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.48 / $24.69 / $87.64
| Facility | | $17.48 | $24.69 | $87.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.50 / $17.48 / $18.36
| Professional | | $10.50 | $17.48 | $18.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.14 / $12.14 / $12.14
| Professional | | $12.14 | $12.14 | $12.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.71 / $21.71 / $52.05
| Facility | | $13.71 | $21.71 | $52.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.50 / $23.03 / $30.98
| Professional | | $13.50 | $23.03 | $30.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.69 / $70.61 / $113.83
| Facility | | $12.69 | $70.61 | $113.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.33 / $12.14 / $20.99
| Professional | | $10.33 | $12.14 | $20.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $9.61 / $13.22
| Professional | | $2.40 | $9.61 | $13.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $10.02 / $31.50
| Professional | | $7.08 | $10.02 | $31.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.48 / $12.02 / $12.02
| Professional | | $10.48 | $12.02 | $12.02 |