- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.17 / $19.01 / $107.03
| Facility | | $10.17 | $19.01 | $107.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.01 / $19.73 / $51.78
| Professional | | $19.01 | $19.73 | $51.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.98 / $21.65 / $25.29
| Facility | | $14.98 | $21.65 | $25.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.61 / $9.61 / $18.30
| Professional | | $8.61 | $9.61 | $18.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.06 / $28.87 / $33.68
| Facility | | $24.06 | $28.87 | $33.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.06 / $29.12 / $48.12
| Professional | | $24.06 | $29.12 | $48.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.64 / $18.72 / $37.86
| Facility | | $15.64 | $18.72 | $37.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.06 / $27.06 / $115.97
| Professional | | $11.06 | $27.06 | $115.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.23 / $13.23 / $13.23
| Professional | | $13.23 | $13.23 | $13.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.61 / $14.44 / $26.47
| Professional | | $9.61 | $14.44 | $26.47 |