- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.48 / $28.73 / $72.18
| Facility | | $16.48 | $28.73 | $72.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.12 / $15.49 / $116.32
| Professional | | $12.12 | $15.49 | $116.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.11 / $39.72 / $66.20
| Facility | | $10.11 | $39.72 | $66.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.48 / $15.24 / $21.72
| Professional | | $10.48 | $15.24 | $21.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.92 / $29.40 / $52.92
| Facility | | $10.92 | $29.40 | $52.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.65 / $18.09 / $22.61
| Professional | | $8.65 | $18.09 | $22.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.05 / $13.33 / $100.00
| Facility | | $9.05 | $13.33 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.58 / $10.85 / $18.09
| Professional | | $10.58 | $10.85 | $18.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.28 / $16.28 / $21.71
| Facility | | $16.28 | $16.28 | $21.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.58 / $10.85 / $18.09
| Professional | | $10.58 | $10.85 | $18.09 |