- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.11 / $20.27 / $68.17
| Facility | | $13.11 | $20.27 | $68.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.56 / $13.05 / $14.63
| Professional | | $10.56 | $13.05 | $14.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.08 / $15.83 / $69.61
| Facility | | $15.08 | $15.83 | $69.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.44 / $12.43 / $40.54
| Professional | | $7.44 | $12.43 | $40.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.78 / $31.62 / $84.63
| Facility | | $19.78 | $31.62 | $84.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.68 / $15.46 / $22.26
| Professional | | $8.68 | $15.46 | $22.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.14 / $24.21 / $100.00
| Facility | | $13.14 | $24.21 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.33 / $10.74 / $18.94
| Professional | | $6.33 | $10.74 | $18.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.43 / $15.08 / $20.68
| Facility | | $5.43 | $15.08 | $20.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.33 / $10.05 / $21.06
| Professional | | $6.33 | $10.05 | $21.06 |