- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.32 / $12.32 / $24.70
| Facility | | $12.32 | $12.32 | $24.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.32 / $12.43 / $3,507.68
| Professional | | $12.32 | $12.43 | $3,507.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.78 / $12.02 / $18.42
| Facility | | $11.78 | $12.02 | $18.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.88 / $12.13 / $12.35
| Professional | | $9.88 | $12.13 | $12.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.97 / $39.54 / $48.13
| Facility | | $22.97 | $39.54 | $48.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.65 / $14.56 / $15.91
| Professional | | $12.65 | $14.56 | $15.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.82 / $36.08 / $45.28
| Facility | | $19.82 | $36.08 | $45.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.53 / $12.53 / $17.03
| Professional | | $12.53 | $12.53 | $17.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.35 / $18.82 / $28.47
| Facility | | $12.35 | $18.82 | $28.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.35 / $12.35 / $17.05
| Professional | | $12.35 | $12.35 | $17.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.32 / $12.32 / $22.18
| Professional | | $12.32 | $12.32 | $22.18 |