- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.57 / $26.44 / $130.10
| Facility | | $16.57 | $26.44 | $130.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.85 / $15.95 / $16.67
| Professional | | $13.85 | $15.95 | $16.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.74 / $10.74 / $10.74
| Professional | | $10.74 | $10.74 | $10.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.13 / $19.25 / $46.04
| Facility | | $12.13 | $19.25 | $46.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.86 / $20.22 / $27.36
| Professional | | $11.86 | $20.22 | $27.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.82 / $101.83 / $164.15
| Facility | | $17.82 | $101.83 | $164.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.74 / $12.40 / $25.02
| Professional | | $10.74 | $12.40 | $25.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $8.59 / $11.81
| Professional | | $2.15 | $8.59 | $11.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.27 / $8.94 / $17.89
| Facility | | $6.27 | $8.94 | $17.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.52 / $10.51 / $25.02
| Professional | | $7.52 | $10.51 | $25.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.27 / $10.74 / $10.74
| Professional | | $9.27 | $10.74 | $10.74 |