- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.75 / $21.84 / $205.07
| Facility | | $15.75 | $21.84 | $205.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.24 / $15.61 / $16.67
| Professional | | $13.24 | $15.61 | $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
- $2.44 / $9.74 / $13.39
| Professional | | $2.44 | $9.74 | $13.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.89 / $17.89 / $26.85
| Facility | | $17.89 | $17.89 | $26.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.16 / $10.51 / $25.02
| Professional | | $7.16 | $10.51 | $25.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.27 / $12.18 / $12.18
| Professional | | $9.27 | $12.18 | $12.18 |