- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.73 / $56.71 / $83.21
| Facility | | $16.73 | $56.71 | $83.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.31 / $16.41 / $118.12
| Professional | | $12.31 | $16.41 | $118.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.76 / $12.76 / $12.76
| Professional | | $12.76 | $12.76 | $12.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.28 / $40.44 / $67.26
| Facility | | $10.28 | $40.44 | $67.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.64 / $15.48 / $22.06
| Professional | | $10.64 | $15.48 | $22.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.85 / $29.85 / $53.73
| Facility | | $12.85 | $29.85 | $53.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.31 / $22.30 / $27.88
| Professional | | $12.31 | $22.30 | $27.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.78 / $16.66 / $334.35
| Facility | | $13.78 | $16.66 | $334.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.72 / $10.78 / $16.92
| Professional | | $7.72 | $10.78 | $16.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.72 / $10.78 / $14.70
| Professional | | $7.72 | $10.78 | $14.70 |