- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.75 / $42.47 / $101.43
| Facility | | $10.75 | $42.47 | $101.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.36 / $11.73 / $14.43
| Professional | | $10.36 | $11.73 | $14.43 |
- 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
- $6.15 / $6.48 / $13.00
| Professional | | $6.15 | $6.48 | $13.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.12 / $15.74 / $18.61
| Facility | | $13.12 | $15.74 | $18.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.12 / $15.87 / $26.24
| Professional | | $13.12 | $15.87 | $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 / $15.28 / $84.46
| Professional | | $6.60 | $15.28 | $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 / $18.32
| Professional | | $5.25 | $11.00 | $18.32 |