- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.73 / $38.44 / $55.70
| Facility | | $13.73 | $38.44 | $55.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.81 / $15.32 / $30.86
| Professional | | $10.81 | $15.32 | $30.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $10.30 / $26.60
| Professional | | $10.30 | $10.30 | $26.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.15 / $18.88 / $30.37
| Facility | | $15.15 | $18.88 | $30.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.48 / $8.48 / $18.53
| Professional | | $8.48 | $8.48 | $18.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.73 / $13.73 / $20.05
| Professional | | $13.73 | $13.73 | $20.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.77 / $17.16 / $23.17
| Facility | | $13.77 | $17.16 | $23.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.59 / $22.31 / $23.17
| Professional | | $14.59 | $22.31 | $23.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.15 / $17.66 / $57.48
| Facility | | $11.15 | $17.66 | $57.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.75 / $13.77 / $24.98
| Professional | | $8.75 | $13.77 | $24.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.15 / $17.66 / $65.09
| Facility | | $11.15 | $17.66 | $65.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.75 / $11.03 / $23.04
| Professional | | $8.75 | $11.03 | $23.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $14.15 / $20.59
| Professional | | $9.44 | $14.15 | $20.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.21 / $10.30 / $22.48
| Professional | | $7.21 | $10.30 | $22.48 |