- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $28.32 / $141.41
| Facility | | $7.08 | $28.32 | $141.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.23 / $11.01 / $12.96
| Professional | | $8.23 | $11.01 | $12.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.00 / $62.54 / $101.55
| Facility | | $17.00 | $62.54 | $101.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.79 / $7.72 / $8.86
| Professional | | $5.79 | $7.72 | $8.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.14 / $6.14 / $6.14
| Facility | | $6.14 | $6.14 | $6.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.92 / $10.74 / $17.76
| Professional | | $5.92 | $10.74 | $17.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.19 / $5.19 / $5.19
| Professional | | $5.19 | $5.19 | $5.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.40 / $11.33 / $18.45
| Facility | | $8.40 | $11.33 | $18.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $9.44 / $17.76
| Professional | | $9.44 | $9.44 | $17.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.96 / $5.58 / $5.78
| Professional | | $3.96 | $5.58 | $5.78 |