- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.32 / $47.28 / $86.81
| Facility | | $18.32 | $47.28 | $86.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.69 / $16.05 / $17.98
| Professional | | $11.69 | $16.05 | $17.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.69 / $12.48 / $12.48
| Professional | | $11.69 | $12.48 | $12.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.06 / $37.54 / $65.79
| Facility | | $10.06 | $37.54 | $65.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.41 / $15.14 / $21.58
| Professional | | $10.41 | $15.14 | $21.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.57 / $29.23 / $52.61
| Facility | | $12.57 | $29.23 | $52.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.69 / $20.65 / $27.36
| Professional | | $11.69 | $20.65 | $27.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.49 / $16.29 / $86.10
| Facility | | $13.49 | $16.29 | $86.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.55 / $10.55 / $16.39
| Professional | | $7.55 | $10.55 | $16.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.55 / $10.36 / $12.60
| Professional | | $7.55 | $10.36 | $12.60 |