- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.05 / $25.11 / $152.74
| Facility | | $13.05 | $25.11 | $152.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.46 / $13.66 / $16.64
| Professional | | $10.46 | $13.66 | $16.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.15 / $24.78 / $44.75
| Facility | | $15.15 | $24.78 | $44.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.03 / $13.54 / $20.78
| Professional | | $10.03 | $13.54 | $20.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.31 / $12.31 / $40.00
| Facility | | $12.31 | $12.31 | $40.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.00 / $26.62 / $86.16
| Facility | | $8.00 | $26.62 | $86.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.91 / $8.07 / $17.55
| Professional | | $5.91 | $8.07 | $17.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.17 / $11.08 / $12.31
| Facility | | $5.17 | $11.08 | $12.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.39 / $10.10 / $23.83
| Professional | | $7.39 | $10.10 | $23.83 |