- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.58 / $17.41 / $18.71
| Facility | | $9.58 | $17.41 | $18.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.71 / $17.41 / $23.07
| Professional | | $13.71 | $17.41 | $23.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.42 / $47.76 / $47.76
| Facility | | $44.42 | $47.76 | $47.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.32 / $16.32 / $16.32
| Professional | | $16.32 | $16.32 | $16.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.28 / $16.53 / $56.94
| Facility | | $8.28 | $16.53 | $56.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.67 / $13.46 / $30.98
| Professional | | $7.67 | $13.46 | $30.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.88 / $13.06 / $22.41
| Facility | | $10.88 | $13.06 | $22.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.41 / $15.74 / $20.81
| Professional | | $10.41 | $15.74 | $20.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.81 / $9.78 / $21.76
| Professional | | $7.81 | $9.78 | $21.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.36 / $103.36 / $121.75
| Facility | | $103.36 | $103.36 | $121.75 |