- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.04 / $24.46 / $82.94
| Facility | | $15.04 | $24.46 | $82.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.49 / $15.64 / $19.10
| Professional | | $10.49 | $15.64 | $19.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.14 / $22.61 / $75.20
| Facility | | $16.14 | $22.61 | $75.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.13 / $18.78 / $40.18
| Professional | | $12.13 | $18.78 | $40.18 |
- 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
- $12.03 / $12.03 / $17.64
| Professional | | $12.03 | $12.03 | $17.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.65 / $10.58 / $18.04
| Professional | | $2.65 | $10.58 | $18.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.22 / $12.03 / $18.05
| Facility | | $10.22 | $12.03 | $18.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.02 / $8.42 / $33.42
| Professional | | $7.02 | $8.42 | $33.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.03 / $12.03 / $12.03
| Professional | | $12.03 | $12.03 | $12.03 |