- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.37 / $22.10 / $85.20
| Facility | | $10.37 | $22.10 | $85.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $12.48 / $22.62
| Professional | | $9.36 | $12.48 | $22.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.36 / $17.00 / $53.98
| Facility | | $10.36 | $17.00 | $53.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.68 / $6.24 / $25.28
| Professional | | $4.68 | $6.24 | $25.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.63 / $15.60 / $24.96
| Facility | | $11.63 | $15.60 | $24.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.11 / $34.32 / $48.06
| Facility | | $15.11 | $34.32 | $48.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.33 / $19.00 / $23.75
| Professional | | $7.33 | $19.00 | $23.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.05 / $20.28 / $43.10
| Professional | | $17.05 | $20.28 | $43.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.04 / $14.04 / $14.04
| Facility | | $14.04 | $14.04 | $14.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.04 / $9.86 / $16.76
| Professional | | $7.04 | $9.86 | $16.76 |