- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $16.68 / $56.36
| Facility | | $15.14 | $16.68 | $56.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.02 / $14.65 / $16.36
| Professional | | $10.02 | $14.65 | $16.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.07 / $42.38 / $68.70
| Facility | | $32.07 | $42.38 | $68.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.36 / $12.30 / $24.69
| Professional | | $11.36 | $12.30 | $24.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.92 / $20.03 / $49.82
| Facility | | $12.92 | $20.03 | $49.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.98 / $14.04 / $27.36
| Professional | | $11.98 | $14.04 | $27.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.02 / $14.65 / $37.04
| Facility | | $10.02 | $14.65 | $37.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.80 / $27.13 / $35.00
| Professional | | $25.80 | $27.13 | $35.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.47 / $12.92 / $25.84
| Professional | | $9.47 | $12.92 | $25.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.00 / $102.67 / $105.44
| Facility | | $86.00 | $102.67 | $105.44 |