- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.35 / $15.38 / $113.64
| Facility | | $6.35 | $15.38 | $113.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.73 / $8.11 / $13.85
| Professional | | $5.73 | $8.11 | $13.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.69 / $10.48 / $33.04
| Facility | | $6.69 | $10.48 | $33.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $4.03 / $15.29
| Professional | | $3.02 | $4.03 | $15.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.44 / $9.55 / $15.28
| Facility | | $6.44 | $9.55 | $15.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.13 / $21.01 / $29.26
| Facility | | $9.13 | $21.01 | $29.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.43 / $11.56 / $14.45
| Professional | | $4.43 | $11.56 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.44 / $12.42 / $25.51
| Professional | | $10.44 | $12.42 | $25.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.01 / $5.73 / $15.02
| Professional | | $4.01 | $5.73 | $15.02 |