- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.13 / $38.28 / $265.54
| Facility | | $13.13 | $38.28 | $265.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.78 / $10.68 / $36.82
| Professional | | $7.78 | $10.68 | $36.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.18 / $16.28 / $24.69
| Professional | | $9.18 | $16.28 | $24.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.61 / $17.16 / $20.59
| Professional | | $14.61 | $17.16 | $20.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.65 / $14.63 / $22.96
| Facility | | $7.65 | $14.63 | $22.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.86 / $14.88 / $20.95
| Professional | | $10.86 | $14.88 | $20.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.63 / $15.72 / $16.38
| Facility | | $11.63 | $15.72 | $16.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.65 / $14.88 / $20.59
| Facility | | $7.65 | $14.88 | $20.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.04 / $16.50 / $21.78
| Professional | | $11.04 | $16.50 | $21.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.71 / $16.94 / $22.08
| Professional | | $9.71 | $16.94 | $22.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.21 / $17.04 / $24.86
| Professional | | $12.21 | $17.04 | $24.86 |