- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.82 / $64.61 / $114.63
| Facility | | $17.82 | $64.61 | $114.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.49 / $17.32 / $26.16
| Professional | | $10.49 | $17.32 | $26.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.14 / $22.61 / $85.40
| Facility | | $16.14 | $22.61 | $85.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.13 / $19.53 / $40.82
| Professional | | $12.13 | $19.53 | $40.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.00 / $9.00 / $13.18
| Facility | | $9.00 | $9.00 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.65 / $13.65 / $17.75
| Professional | | $13.65 | $13.65 | $17.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $12.01 / $20.47
| Professional | | $3.00 | $12.01 | $20.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.75 / $22.75 / $22.75
| Facility | | $22.75 | $22.75 | $22.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.91 / $9.56 / $44.48
| Professional | | $6.91 | $9.56 | $44.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.65 / $13.65 / $13.65
| Professional | | $13.65 | $13.65 | $13.65 |