- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.25 / $27.51 / $71.94
| Facility | | $13.25 | $27.51 | $71.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $16.29 / $16.64
| Professional | | $12.05 | $16.29 | $16.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.48 / $12.48 / $12.48
| Professional | | $12.48 | $12.48 | $12.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.06 / $39.56 / $65.79
| Facility | | $10.06 | $39.56 | $65.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.41 / $15.14 / $21.58
| Professional | | $10.41 | $15.14 | $21.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.36 / $29.23 / $52.61
| Facility | | $12.36 | $29.23 | $52.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.15 / $21.89 / $27.36
| Professional | | $12.15 | $21.89 | $27.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.49 / $16.66 / $85.41
| Facility | | $13.49 | $16.66 | $85.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.55 / $10.63 / $14.38
| Professional | | $7.55 | $10.63 | $14.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.55 / $10.63 / $14.38
| Professional | | $7.55 | $10.63 | $14.38 |