- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $87.10 / $537.03
| Facility | | $12.59 | $87.10 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $21.88 / $107.15
| Professional | | $11.22 | $21.88 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $14.45 / $46.77
| Professional | | $10.23 | $14.45 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $12.02 / $14.79
| Professional | | $12.02 | $12.02 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $13.80 / $18.20
| Facility | | $10.96 | $13.80 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $46.77 / $63.10
| Professional | | $14.45 | $46.77 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $19.50 / $22.91
| Facility | | $19.50 | $19.50 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $47.86 / $234.42
| Professional | | $12.30 | $47.86 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $32.36 / $38.90
| Professional | | $10.00 | $32.36 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $36.31 / $72.44
| Professional | | $12.02 | $36.31 | $72.44 |