- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $27.54 / $309.03
| Facility | | $9.77 | $27.54 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $9.77 / $10.72
| Professional | | $8.91 | $9.77 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.05 / $2.14 / $4.37
| Facility | | $1.05 | $2.14 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.25 / $0.26 / $0.26
| Professional | | $0.25 | $0.26 | $0.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $10.47
| Professional | | $10.47 | $10.47 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $25.70 / $30.90
| Facility | | $7.08 | $25.70 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $9.77 / $12.30
| Professional | | $8.71 | $9.77 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $10.47
| Professional | | $10.47 | $10.47 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.78 / $0.78 / $0.78
| Facility | | $0.78 | $0.78 | $0.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $10.72 / $11.48
| Professional | | $10.23 | $10.72 | $11.48 |