- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.19 / $11.54 / $35.70
| Facility | | $10.19 | $11.54 | $35.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.92 / $10.74 / $14.53
| Professional | | $8.92 | $10.74 | $14.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.73 / $39.33 / $44.42
| Facility | | $22.73 | $39.33 | $44.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.07 / $12.08 / $19.50
| Professional | | $10.07 | $12.08 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.30 / $12.69 / $35.59
| Facility | | $8.30 | $12.69 | $35.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.65 / $8.75 / $19.10
| Professional | | $7.65 | $8.75 | $19.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.05 / $14.52 / $22.41
| Facility | | $8.05 | $14.52 | $22.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.28 / $15.74 / $21.00
| Professional | | $10.28 | $15.74 | $21.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.06 / $15.84 / $20.62
| Facility | | $10.06 | $15.84 | $20.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $8.05 / $15.62
| Professional | | $6.46 | $8.05 | $15.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.21 / $70.00 / $70.00
| Facility | | $35.21 | $70.00 | $70.00 |