- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.32 / $16.72 / $86.15
| Facility | | $10.32 | $16.72 | $86.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.36 / $8.36 / $14.17
| Professional | | $8.36 | $8.36 | $14.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.99 / $13.78 / $104.39
| Facility | | $9.99 | $13.78 | $104.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.13 / $4.13 / $11.94
| Professional | | $4.13 | $4.13 | $11.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.37 / $14.55 / $22.02
| Facility | | $12.37 | $14.55 | $22.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.48 / $14.05 / $15.03
| Professional | | $10.48 | $14.05 | $15.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.32 / $10.32 / $12.50
| Professional | | $10.32 | $10.32 | $12.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.32 / $10.32 / $86.15
| Facility | | $10.32 | $10.32 | $86.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.36 / $10.32 / $12.04
| Professional | | $8.36 | $10.32 | $12.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.19 / $8.44 / $20.39
| Professional | | $6.19 | $8.44 | $20.39 |