- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $6.31 / $16.22
| Facility | | $6.31 | $6.31 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $22.39 / $72.44
| Professional | | $8.91 | $22.39 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $10.72 / $16.22
| Professional | | $9.12 | $10.72 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $12.59 / $21.88
| Professional | | $11.22 | $12.59 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $18.20 / $18.20
| Facility | | $18.20 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $13.80 / $23.99
| Professional | | $8.91 | $13.80 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $18.20 / $25.12
| Professional | | $13.49 | $18.20 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $9.55 / $10.00
| Facility | | $9.55 | $9.55 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $12.59 / $28.18
| Professional | | $9.33 | $12.59 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $6.31 / $16.22
| Facility | | $6.31 | $6.31 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $18.62 / $52.48
| Professional | | $8.91 | $18.62 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $15.85 / $20.89
| Professional | | $15.14 | $15.85 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $11.22 / $19.05
| Professional | | $9.12 | $11.22 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.51 / $12.30 / $23.44
| Professional | | $8.51 | $12.30 | $23.44 |