- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.70 / $22.04 / $25.11
| Facility | | $11.70 | $22.04 | $25.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $9.36 / $10.63
| Professional | | $5.62 | $9.36 | $10.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.92 / $36.96 / $54.75
| Facility | | $32.92 | $36.96 | $54.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.81 / $21.81 / $116.20
| Professional | | $21.81 | $21.81 | $116.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.99 / $13.36 / $58.36
| Facility | | $6.99 | $13.36 | $58.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.39 / $15.49 / $41.00
| Professional | | $6.39 | $15.49 | $41.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.44 / $9.44 / $19.60
| Facility | | $9.44 | $9.44 | $19.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.46 / $8.50 / $21.42
| Professional | | $4.46 | $8.50 | $21.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.42 / $8.50 / $22.12
| Professional | | $5.42 | $8.50 | $22.12 |