- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.90 / $47.53 / $130.02
| Facility | | $10.90 | $47.53 | $130.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.24 / $12.94 / $13.14
| Professional | | $10.24 | $12.94 | $13.14 |
- 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
- $4.82 / $8.84 / $23.73
| Professional | | $4.82 | $8.84 | $23.73 |
- 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
- $10.85 / $20.97 / $60.00
| Facility | | $10.85 | $20.97 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $7.23 / $13.62
| Professional | | $5.05 | $7.23 | $13.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.34 / $12.05 / $14.46
| Facility | | $4.34 | $12.05 | $14.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $7.23 / $14.46
| Professional | | $5.05 | $7.23 | $14.46 |