- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $42.11 / $149.47
| Facility | | $10.72 | $42.11 | $149.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $11.40 / $12.76
| Professional | | $9.44 | $11.40 | $12.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.08 / $11.48 / $38.28
| Facility | | $10.08 | $11.48 | $38.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.74 / $6.30 / $9.36
| Professional | | $5.74 | $6.30 | $9.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.76 / $14.04 / $17.86
| Facility | | $12.76 | $14.04 | $17.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.28 / $13.40 / $17.23
| Professional | | $8.28 | $13.40 | $17.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.34 / $12.76 / $32.69
| Facility | | $9.34 | $12.76 | $32.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.40 / $15.62 / $28.54
| Professional | | $8.40 | $15.62 | $28.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.76 / $12.76 / $27.92
| Facility | | $12.76 | $12.76 | $27.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.36 / $8.19 / $12.76
| Professional | | $5.36 | $8.19 | $12.76 |