- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.01 / $17.57 / $29.43
| Facility | | $13.01 | $17.57 | $29.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.59 / $10.84 / $13.33
| Professional | | $6.59 | $10.84 | $13.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.16 / $12.02 / $17.80
| Facility | | $10.16 | $12.02 | $17.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.38 / $13.38 / $75.45
| Professional | | $13.38 | $13.38 | $75.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.19 / $16.01 / $70.03
| Facility | | $8.19 | $16.01 | $70.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.60 / $18.07 / $31.00
| Professional | | $7.60 | $18.07 | $31.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.34 / $10.86 / $23.72
| Facility | | $10.34 | $10.86 | $23.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $7.48 / $19.94
| Professional | | $4.84 | $7.48 | $19.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.27 / $34.27 / $34.27
| Facility | | $34.27 | $34.27 | $34.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $7.48 / $25.93
| Professional | | $4.84 | $7.48 | $25.93 |