- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.85 / $42.84 / $327.86
| Facility | | $10.85 | $42.84 | $327.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.17 / $10.11 / $10.53
| Professional | | $9.17 | $10.11 | $10.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.17 / $10.58 / $34.83
| Facility | | $9.17 | $10.58 | $34.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.48 / $5.73 / $8.22
| Professional | | $5.48 | $5.73 | $8.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.61 / $12.77 / $16.25
| Facility | | $11.61 | $12.77 | $16.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.55 / $12.19 / $15.67
| Professional | | $7.55 | $12.19 | $15.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.49 / $11.61 / $30.20
| Facility | | $8.49 | $11.61 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.64 / $13.22 / $25.92
| Professional | | $7.64 | $13.22 | $25.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.61 / $11.61 / $26.04
| Facility | | $11.61 | $11.61 | $26.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.88 / $7.55 / $14.32
| Professional | | $4.88 | $7.55 | $14.32 |