- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $23.68 / $29.97
| Professional | | $16.60 | $23.68 | $29.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.43 / $32.57 / $32.57
| Professional | | $24.43 | $32.57 | $32.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.00 / $51.00 / $64.29
| Professional | | $38.00 | $51.00 | $64.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.27 / $24.27 / $37.24
| Facility | | $24.27 | $24.27 | $37.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.63 / $24.27 / $32.49
| Professional | | $20.63 | $24.27 | $32.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.46 / $29.97 / $75.45
| Facility | | $22.46 | $29.97 | $75.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Professional | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.46 / $18.41 / $24.55
| Professional | | $2.46 | $18.41 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.00 / $17.43 / $25.96
| Facility | | $2.00 | $17.43 | $25.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.31 / $21.25 / $34.17
| Professional | | $14.31 | $21.25 | $34.17 |