- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.62 / $42.94 / $143.47
| Facility | | $13.62 | $42.94 | $143.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.67 / $9.97 / $10.36
| Professional | | $9.67 | $9.97 | $10.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.05 / $12.65 / $55.62
| Facility | | $12.05 | $12.65 | $55.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.61 / $8.84 / $22.71
| Professional | | $4.61 | $8.84 | $22.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.59 / $25.27 / $28.71
| Facility | | $16.59 | $25.27 | $28.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.29 / $5.86 / $17.04
| Professional | | $5.29 | $5.86 | $17.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.05 / $20.97 / $60.00
| Facility | | $10.05 | $20.97 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $6.92 / $13.03
| Professional | | $4.84 | $6.92 | $13.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.42 / $12.05 / $12.05
| Facility | | $5.42 | $12.05 | $12.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $6.92 / $14.46
| Professional | | $4.84 | $6.92 | $14.46 |