- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $43.65 / $87.10
| Facility | | $10.96 | $43.65 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $12.02 / $18.62
| Professional | | $10.00 | $12.02 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $16.22 / $40.74
| Facility | | $10.47 | $16.22 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $11.22 / $26.92
| Professional | | $8.71 | $11.22 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.80 / $64.57 / $120.23
| Facility | | $13.80 | $64.57 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $9.55 / $18.20
| Professional | | $9.55 | $9.55 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $8.51 / $11.75
| Professional | | $2.14 | $8.51 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.76 / $10.00 / $16.22
| Facility | | $6.76 | $10.00 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $7.76 / $18.62
| Professional | | $5.62 | $7.76 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $15.85
| Professional | | $10.47 | $10.47 | $15.85 |