- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.52 / $29.60 / $34.04
| Facility | | $10.52 | $29.60 | $34.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.52 / $10.52 / $17.64
| Professional | | $10.52 | $10.52 | $17.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.61 / $10.14 / $10.14
| Facility | | $7.61 | $10.14 | $10.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.63 / $10.02 / $10.14
| Professional | | $9.63 | $10.02 | $10.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.94 / $9.38 / $11.72
| Professional | | $8.94 | $9.38 | $11.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.40 / $19.98 / $100.00
| Facility | | $15.40 | $19.98 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.86 / $15.40 / $15.40
| Professional | | $13.86 | $15.40 | $15.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.20 / $14.15 / $20.90
| Facility | | $13.20 | $14.15 | $20.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.46 / $15.51 / $28.38
| Professional | | $12.46 | $15.51 | $28.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.63 / $15.40 / $15.40
| Professional | | $14.63 | $15.40 | $15.40 |