- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.42 / $35.26 / $52.46
| Facility | | $21.42 | $35.26 | $52.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.07 / $32.13 / $176.08
| Professional | | $16.07 | $32.13 | $176.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.53 / $21.42 / $26.78
| Facility | | $9.53 | $21.42 | $26.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.13 / $12.13 / $27.30
| Professional | | $12.13 | $12.13 | $27.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.92 / $25.06 / $77.53
| Facility | | $13.92 | $25.06 | $77.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.64 / $16.10 / $30.95
| Professional | | $15.64 | $16.10 | $30.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.36 / $7.36 / $22.49
| Professional | | $7.36 | $7.36 | $22.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.36 / $7.36 / $7.36
| Professional | | $7.36 | $7.36 | $7.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.13 / $32.13 / $32.13
| Facility | | $32.13 | $32.13 | $32.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.85 / $17.87 / $37.22
| Professional | | $12.85 | $17.87 | $37.22 |