- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.38 / $33.88 / $165.96
| Facility | | $17.38 | $33.88 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $14.13 / $51.29
| Professional | | $7.08 | $14.13 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $12.59 / $12.59
| Professional | | $12.59 | $12.59 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.41 / $11.22 / $52.48
| Facility | | $7.41 | $11.22 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.89 / $10.23 / $34.67
| Professional | | $5.89 | $10.23 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $44.67 / $83.18
| Facility | | $9.33 | $44.67 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $12.30 / $18.62
| Professional | | $12.30 | $12.30 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $9.77 / $13.49
| Professional | | $2.45 | $9.77 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $12.30 / $20.42
| Facility | | $6.31 | $12.30 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $7.41 / $16.98
| Professional | | $4.57 | $7.41 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $12.30 / $20.42
| Professional | | $12.30 | $12.30 | $20.42 |