- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.28 / $17.03 / $29.74
| Facility | | $9.28 | $17.03 | $29.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.53 / $17.76 / $32.36
| Professional | | $10.53 | $17.76 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.43 / $7.43 / $7.43
| Professional | | $7.43 | $7.43 | $7.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.74 / $27.85 / $40.33
| Facility | | $20.74 | $27.85 | $40.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.77 / $11.77 / $12.39
| Professional | | $11.77 | $11.77 | $12.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.05 / $8.66 / $20.23
| Facility | | $8.05 | $8.66 | $20.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.48 / $12.46 / $17.55
| Professional | | $5.48 | $12.46 | $17.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.81 / $10.81 / $112.08
| Facility | | $10.81 | $10.81 | $112.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.20 / $7.08 / $15.49
| Professional | | $5.20 | $7.08 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.20 / $6.20 / $8.05
| Professional | | $5.20 | $6.20 | $8.05 |