- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.81 / $31.55 / $271.36
| Facility | | $14.81 | $31.55 | $271.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.05 / $11.68 / $23.36
| Professional | | $10.05 | $11.68 | $23.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.73 / $7.73 / $7.73
| Professional | | $7.73 | $7.73 | $7.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.73 / $12.88 / $16.10
| Facility | | $5.73 | $12.88 | $16.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.36 / $7.79 / $9.89
| Professional | | $6.36 | $7.79 | $9.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.36 / $15.07 / $46.62
| Facility | | $8.36 | $15.07 | $46.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.72 / $14.87 / $18.59
| Professional | | $9.72 | $14.87 | $18.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.11 / $12.88 / $13.52
| Professional | | $0.11 | $12.88 | $13.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.43 / $4.43 / $4.43
| Professional | | $4.43 | $4.43 | $4.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.32 / $19.32 / $19.32
| Facility | | $19.32 | $19.32 | $19.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $7.56 / $12.88
| Professional | | $5.25 | $7.56 | $12.88 |