- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.09 / $36.72 / $168.48
| Facility | | $10.09 | $36.72 | $168.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.78 / $11.65 / $14.36
| Professional | | $9.78 | $11.65 | $14.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.79 / $37.71 / $59.77
| Facility | | $13.79 | $37.71 | $59.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.48 / $5.48 / $10.88
| Professional | | $5.48 | $5.48 | $10.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.63 / $12.47 / $33.58
| Facility | | $7.63 | $12.47 | $33.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.98 / $11.94 / $18.59
| Professional | | $7.98 | $11.94 | $18.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.92 / $15.66 / $25.72
| Facility | | $9.92 | $15.66 | $25.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.74 / $16.97 / $48.15
| Professional | | $8.74 | $16.97 | $48.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.48 / $7.66 / $9.66
| Professional | | $5.48 | $7.66 | $9.66 |