- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.84 / $47.70 / $118.59
| Facility | | $10.84 | $47.70 | $118.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.07 / $11.65 / $17.78
| Professional | | $9.07 | $11.65 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.48 / $8.99 / $9.92
| Professional | | $6.48 | $8.99 | $9.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.25 / $27.06 / $47.42
| Facility | | $7.25 | $27.06 | $47.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.50 / $10.91 / $15.55
| Professional | | $7.50 | $10.91 | $15.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.06 / $21.05 / $37.89
| Facility | | $9.06 | $21.05 | $37.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.65 / $15.69 / $19.61
| Professional | | $8.65 | $15.69 | $19.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.36 / $11.74 / $70.00
| Facility | | $10.36 | $11.74 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.44 / $7.60 / $11.92
| Professional | | $5.44 | $7.60 | $11.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.44 / $7.60 / $10.50
| Professional | | $5.44 | $7.60 | $10.50 |