- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.40 / $12.98 / $22.41
| Facility | | $8.40 | $12.98 | $22.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.21 / $8.40 / $10.34
| Professional | | $8.21 | $8.40 | $10.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.66 / $10.14 / $44.59
| Facility | | $9.66 | $10.14 | $44.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.66 / $7.09 / $25.38
| Professional | | $4.66 | $7.09 | $25.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.44 / $20.27 / $52.53
| Facility | | $12.44 | $20.27 | $52.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.48 / $9.84 / $14.03
| Professional | | $5.48 | $9.84 | $14.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.12 / $15.15 / $70.00
| Facility | | $5.12 | $15.15 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $7.00 / $11.86
| Professional | | $4.05 | $7.00 | $11.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.48 / $9.66 / $12.95
| Facility | | $3.48 | $9.66 | $12.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $5.80 / $11.86
| Professional | | $4.05 | $5.80 | $11.86 |