- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.02 / $10.76 / $128.87
| Facility | | $8.02 | $10.76 | $128.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.36 / $11.02 / $12.07
| Professional | | $10.36 | $11.02 | $12.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.17 / $11.81 / $13.79
| Facility | | $8.17 | $11.81 | $13.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.20 / $6.20 / $13.65
| Professional | | $6.20 | $6.20 | $13.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.12 / $18.37 / $21.65
| Facility | | $13.12 | $18.37 | $21.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.04 / $17.05 / $26.24
| Professional | | $14.04 | $17.05 | $26.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.52 / $10.21 / $27.87
| Facility | | $8.52 | $10.21 | $27.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.60 / $15.00 / $84.46
| Professional | | $6.60 | $15.00 | $84.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.22 / $7.22 / $7.22
| Professional | | $7.22 | $7.22 | $7.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $11.00 / $17.20
| Professional | | $5.25 | $11.00 | $17.20 |