- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.91 / $18.60 / $63.32
| Facility | | $17.91 | $18.60 | $63.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.67 / $11.77 / $19.86
| Professional | | $10.67 | $11.77 | $19.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.68 / $10.68 / $13.10
| Professional | | $10.68 | $10.68 | $13.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.78 / $19.86 / $87.79
| Facility | | $10.78 | $19.86 | $87.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.68 / $10.68 / $24.03
| Professional | | $10.68 | $10.68 | $24.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.01 / $58.80 / $92.40
| Facility | | $17.01 | $58.80 | $92.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.00 / $50.40 / $50.40
| Professional | | $42.00 | $50.40 | $50.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.86 / $27.80 / $87.79
| Facility | | $19.86 | $27.80 | $87.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.68 / $17.10 / $42.00
| Professional | | $10.68 | $17.10 | $42.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.32 / $16.02 / $32.04
| Professional | | $11.32 | $16.02 | $32.04 |