- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.64 / $28.34 / $78.09
| Facility | | $13.64 | $28.34 | $78.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.39 / $12.39 / $32.36
| Professional | | $10.39 | $12.39 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.60 / $8.60 / $8.60
| Professional | | $8.60 | $8.60 | $8.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.07 / $22.49 / $33.56
| Facility | | $19.07 | $22.49 | $33.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.82 / $17.82 / $24.83
| Professional | | $17.82 | $17.82 | $24.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.15 / $15.93 / $68.58
| Facility | | $8.15 | $15.93 | $68.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.60 / $17.55 / $30.00
| Professional | | $7.60 | $17.55 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.81 / $10.81 / $39.83
| Facility | | $10.81 | $10.81 | $39.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $7.43 / $25.28
| Professional | | $4.84 | $7.43 | $25.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $7.43 / $25.78
| Professional | | $4.84 | $7.43 | $25.78 |