- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.30 / $28.53 / $49.86
| Facility | | $10.30 | $28.53 | $49.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.16 / $12.74 / $23.28
| Professional | | $10.16 | $12.74 | $23.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.32 / $39.15 / $62.06
| Facility | | $14.32 | $39.15 | $62.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.69 / $5.69 / $10.40
| Professional | | $5.69 | $5.69 | $10.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.93 / $12.95 / $34.89
| Facility | | $7.93 | $12.95 | $34.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.27 / $12.40 / $19.62
| Professional | | $8.27 | $12.40 | $19.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.30 / $16.26 / $26.71
| Facility | | $10.30 | $16.26 | $26.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.08 / $17.62 / $50.00
| Professional | | $9.08 | $17.62 | $50.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.05 / $17.05 / $17.05
| Facility | | $17.05 | $17.05 | $17.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.69 / $7.95 / $10.02
| Professional | | $5.69 | $7.95 | $10.02 |