- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.30 / $53.26 / $135.52
| Facility | | $6.30 | $53.26 | $135.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $22.24 / $23.15
| Professional | | $20.42 | $22.24 | $23.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.89 / $22.98 / $26.83
| Facility | | $15.89 | $22.98 | $26.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.08 / $12.61 / $25.30
| Professional | | $12.08 | $12.61 | $25.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.53 / $35.74 / $42.12
| Facility | | $25.53 | $35.74 | $42.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.32 / $33.19 / $51.06
| Professional | | $27.32 | $33.19 | $51.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.59 / $19.86 / $46.30
| Facility | | $16.59 | $19.86 | $46.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.04 / $29.32 / $163.44
| Professional | | $13.04 | $29.32 | $163.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.04 / $14.04 / $14.04
| Professional | | $14.04 | $14.04 | $14.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $21.40 / $33.03
| Professional | | $10.72 | $21.40 | $33.03 |