- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.48 / $36.50 / $136.21
| Facility | | $10.48 | $36.50 | $136.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $10.02 / $12.39
| Professional | | $8.32 | $10.02 | $12.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.63 / $6.76 / $7.82
| Professional | | $5.63 | $6.76 | $7.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.62 / $12.06 / $28.95
| Facility | | $7.62 | $12.06 | $28.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $12.92 / $17.04
| Professional | | $7.41 | $12.92 | $17.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.20 / $62.32 / $100.45
| Facility | | $11.20 | $62.32 | $100.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $7.79 / $15.73
| Professional | | $6.76 | $7.79 | $15.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $5.41 / $7.43
| Professional | | $1.35 | $5.41 | $7.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.73 / $6.76 / $15.73
| Professional | | $4.73 | $6.76 | $15.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.83 / $6.76 / $6.76
| Professional | | $5.83 | $6.76 | $6.76 |