- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.35 / $23.68 / $7,123.64
| Facility | | $12.35 | $23.68 | $7,123.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.32 / $20.73 / $5,907.20
| Professional | | $12.32 | $20.73 | $5,907.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.46 / $13.25 / $13.95
| Facility | | $10.46 | $13.25 | $13.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.25 / $13.81 / $13.98
| Professional | | $13.25 | $13.81 | $13.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.32 / $12.53 / $15.66
| Professional | | $12.32 | $12.53 | $15.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.77 / $23.47 / $85.00
| Facility | | $12.77 | $23.47 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.27 / $12.35 / $14.63
| Professional | | $12.27 | $12.35 | $14.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.73 / $20.01 / $25.47
| Facility | | $14.73 | $20.01 | $25.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.14 / $14.73 / $18.42
| Professional | | $14.14 | $14.73 | $18.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.70 / $12.32 / $13.55
| Professional | | $11.70 | $12.32 | $13.55 |