- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.14 / $31.01 / $55.77
| Facility | | $14.14 | $31.01 | $55.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.66 / $10.10 / $35.45
| Professional | | $8.66 | $10.10 | $35.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.28 / $24.15 / $30.19
| Professional | | $15.28 | $24.15 | $30.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.12 / $22.96 / $97.25
| Professional | | $13.12 | $22.96 | $97.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.12 / $22.00 / $63.09
| Facility | | $13.12 | $22.00 | $63.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.87 / $13.51 / $35.47
| Professional | | $7.87 | $13.51 | $35.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.07 / $26.73 / $41.13
| Facility | | $16.07 | $26.73 | $41.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.76 / $26.73 / $37.59
| Professional | | $15.76 | $26.73 | $37.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.87 / $11.00 / $33.18
| Professional | | $7.87 | $11.00 | $33.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.36 / $13.12 / $13.12
| Professional | | $10.36 | $13.12 | $13.12 |