- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $16.98 / $102.33
| Facility | | $8.91 | $16.98 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.94 / $10.72 / $12.02
| Professional | | $7.94 | $10.72 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $43.65 / $58.88
| Facility | | $29.51 | $43.65 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $11.48 / $12.02
| Professional | | $11.48 | $11.48 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.76 / $10.23 / $19.50
| Facility | | $7.76 | $10.23 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $12.30 / $16.98
| Professional | | $7.08 | $12.30 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.23 / $12.02 / $131.83
| Facility | | $10.23 | $12.02 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $6.92 / $15.85
| Professional | | $5.01 | $6.92 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.37 / $12.02 / $14.45
| Facility | | $4.37 | $12.02 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $6.92 / $10.23
| Professional | | $5.01 | $6.92 | $10.23 |