- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.01 / $16.50 / $28.82
| Facility | | $9.01 | $16.50 | $28.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.40 / $30.96 / $32.67
| Professional | | $10.40 | $30.96 | $32.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.34 / $24.87 / $36.04
| Facility | | $18.34 | $24.87 | $36.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.41 / $11.41 / $12.01
| Professional | | $11.41 | $11.41 | $12.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.81 / $8.40 / $19.61
| Facility | | $7.81 | $8.40 | $19.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.33 / $12.19 / $17.04
| Professional | | $5.33 | $12.19 | $17.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.48 / $10.48 / $78.00
| Facility | | $10.48 | $10.48 | $78.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.04 / $6.86 / $15.01
| Professional | | $5.04 | $6.86 | $15.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.88 / $51.88 / $51.88
| Facility | | $51.88 | $51.88 | $51.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.04 / $6.61 / $12.01
| Professional | | $5.04 | $6.61 | $12.01 |