- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.52 / $41.22 / $127.26
| Facility | | $13.52 | $41.22 | $127.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.85 / $11.98 / $13.74
| Professional | | $10.85 | $11.98 | $13.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.87 / $6.87 / $6.87
| Professional | | $6.87 | $6.87 | $6.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.85 / $12.55 / $41.22
| Facility | | $10.85 | $12.55 | $41.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $6.79 / $10.08
| Professional | | $6.50 | $6.79 | $10.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.74 / $15.11 / $19.23
| Facility | | $13.74 | $15.11 | $19.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.93 / $14.43 / $18.55
| Professional | | $8.93 | $14.43 | $18.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.05 / $13.74 / $35.21
| Facility | | $10.05 | $13.74 | $35.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.05 / $15.69 / $34.56
| Professional | | $9.05 | $15.69 | $34.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.77 / $8.40 / $12.88
| Professional | | $5.77 | $8.40 | $12.88 |