- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.39 / $10.47 / $63.66
| Facility | | $9.39 | $10.47 | $63.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $11.68
| Professional | | $10.47 | $10.47 | $11.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.52 / $42.24 / $82.63
| Facility | | $24.52 | $42.24 | $82.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.42 / $16.76 / $30.00
| Professional | | $13.42 | $16.76 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.38 / $38.89 / $80.98
| Facility | | $24.38 | $38.89 | $80.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.08 / $7.53 / $19.10
| Professional | | $6.08 | $7.53 | $19.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.06 / $13.85 / $23.46
| Facility | | $10.06 | $13.85 | $23.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.74 / $17.18 / $22.00
| Professional | | $15.74 | $17.18 | $22.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.38 / $7.38 / $10.63
| Professional | | $7.38 | $7.38 | $10.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.64 / $8.25 / $24.16
| Professional | | $5.64 | $8.25 | $24.16 |