- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.82 / $16.41 / $71.44
| Facility | | $11.82 | $16.41 | $71.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.37 / $10.87 / $13.13
| Professional | | $10.37 | $10.87 | $13.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.07 / $15.64 / $27.47
| Facility | | $11.07 | $15.64 | $27.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.05 / $10.37 / $14.00
| Professional | | $7.05 | $10.37 | $14.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.37 / $13.82 / $33.77
| Facility | | $10.37 | $13.82 | $33.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.98 / $8.98 / $13.82
| Professional | | $8.98 | $8.98 | $13.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.22 / $16.11 / $20.13
| Professional | | $9.22 | $16.11 | $20.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.05 / $15.97 / $71.44
| Facility | | $12.05 | $15.97 | $71.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.45 / $14.74 / $18.28
| Professional | | $10.45 | $14.74 | $18.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.29 / $11.44 / $15.44
| Professional | | $10.29 | $11.44 | $15.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.80 / $8.84 / $13.82
| Professional | | $5.80 | $8.84 | $13.82 |