- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.76 / $21.78 / $171.12
| Facility | | $10.76 | $21.78 | $171.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.36 / $11.73 / $14.43
| Professional | | $10.36 | $11.73 | $14.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.12 / $13.12 / $13.12
| Professional | | $13.12 | $13.12 | $13.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.36 / $11.87 / $39.36
| Facility | | $10.36 | $11.87 | $39.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.15 / $6.48 / $9.63
| Professional | | $6.15 | $6.48 | $9.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.12 / $14.43 / $18.37
| Facility | | $13.12 | $14.43 | $18.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.52 / $13.78 / $17.71
| Professional | | $8.52 | $13.78 | $17.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.60 / $13.12 / $33.54
| Facility | | $9.60 | $13.12 | $33.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.64 / $15.28 / $32.99
| Professional | | $8.64 | $15.28 | $32.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.51 / $8.02 / $13.12
| Professional | | $5.51 | $8.02 | $13.12 |