- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.51 / $25.10 / $151.88
| Facility | | $13.51 | $25.10 | $151.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.56 / $13.74 / $19.46
| Professional | | $10.56 | $13.74 | $19.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.94 / $10.94 / $10.94
| Professional | | $10.94 | $10.94 | $10.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.82 / $32.92 / $57.68
| Facility | | $8.82 | $32.92 | $57.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.13 / $13.28 / $18.92
| Professional | | $9.13 | $13.28 | $18.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.04 / $25.60 / $46.08
| Facility | | $11.04 | $25.60 | $46.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.65 / $19.41 / $24.26
| Professional | | $10.65 | $19.41 | $24.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.82 / $13.74 / $165.00
| Facility | | $11.82 | $13.74 | $165.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.62 / $9.25 / $14.38
| Professional | | $6.62 | $9.25 | $14.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.62 / $9.25 / $12.61
| Professional | | $6.62 | $9.25 | $12.61 |