- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $16.98 / $39.81
| Facility | | $8.91 | $16.98 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $18.20 / $33.88
| Professional | | $10.00 | $18.20 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $22.91
| Professional | | $22.91 | $22.91 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $19.05 / $34.67
| Facility | | $12.59 | $19.05 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $21.88 / $42.66
| Professional | | $12.59 | $21.88 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $19.50 / $30.20
| Professional | | $10.00 | $19.50 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $39.81
| Professional | | $32.36 | $33.11 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $15.14 / $20.42
| Facility | | $0.02 | $15.14 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $17.78 / $33.11
| Professional | | $10.47 | $17.78 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $20.42 / $25.12
| Professional | | $10.23 | $20.42 | $25.12 |