- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.83 / $47.65 / $221.32
| Facility | | $13.83 | $47.65 | $221.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.63 / $25.54 / $30.06
| Professional | | $11.63 | $25.54 | $30.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $9.02 / $9.02
| Professional | | $9.02 | $9.02 | $9.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.85 / $19.21 / $52.00
| Facility | | $10.85 | $19.21 | $52.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.56 / $7.42 / $30.12
| Professional | | $5.56 | $7.42 | $30.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.07 / $15.03 / $24.05
| Facility | | $12.07 | $15.03 | $24.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.83 / $33.07 / $46.58
| Facility | | $14.83 | $33.07 | $46.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.32 / $18.17 / $22.71
| Professional | | $9.32 | $18.17 | $22.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.42 / $19.54 / $54.00
| Professional | | $16.42 | $19.54 | $54.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.53 / $13.53 / $18.60
| Facility | | $13.53 | $13.53 | $18.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.31 / $10.65 / $26.31
| Professional | | $6.31 | $10.65 | $26.31 |