- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.91 / $34.92 / $111.94
| Facility | | $10.91 | $34.92 | $111.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.41 / $12.67 / $24.74
| Professional | | $8.41 | $12.67 | $24.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.64 / $8.73 / $10.11
| Professional | | $3.64 | $8.73 | $10.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.43 / $69.06 / $100.04
| Facility | | $51.43 | $69.06 | $100.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.82 / $13.82 / $14.87
| Professional | | $13.82 | $13.82 | $14.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.46 / $10.17 / $23.75
| Facility | | $9.46 | $10.17 | $23.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.48 / $14.58 / $21.17
| Professional | | $6.48 | $14.58 | $21.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.68 / $14.55 / $100.00
| Facility | | $12.68 | $14.55 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.11 / $8.38 / $20.32
| Professional | | $6.11 | $8.38 | $20.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.11 / $8.00 / $14.55
| Professional | | $6.11 | $8.00 | $14.55 |