- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.61 / $107.33 / $134.99
| Facility | | $12.61 | $107.33 | $134.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.52 / $12.85 / $17.55
| Professional | | $9.52 | $12.85 | $17.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.54 / $14.54 / $14.54
| Professional | | $14.54 | $14.54 | $14.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.66 / $13.44 / $13.44
| Facility | | $9.66 | $13.44 | $13.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.42 / $11.42 / $13.84
| Professional | | $11.42 | $11.42 | $13.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.28 / $61.58 / $98.71
| Facility | | $15.28 | $61.58 | $98.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.21 / $16.02 / $22.36
| Professional | | $11.21 | $16.02 | $22.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $5.73 / $6.30
| Professional | | $3.72 | $5.73 | $6.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.44 / $8.61 / $14.24
| Facility | | $6.44 | $8.61 | $14.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.68 / $10.93 / $13.62
| Professional | | $7.68 | $10.93 | $13.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.73 / $5.73 / $10.09
| Professional | | $5.73 | $5.73 | $10.09 |