- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.72 / $47.62 / $81.09
| Facility | | $31.72 | $47.62 | $81.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.72 / $47.75 / $77.37
| Professional | | $31.72 | $47.75 | $77.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.20 / $36.88 / $40.18
| Facility | | $33.20 | $36.88 | $40.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.07 / $35.71 / $35.71
| Professional | | $31.07 | $35.71 | $35.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.23 / $53.23 / $53.23
| Facility | | $53.23 | $53.23 | $53.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.04 / $60.81 / $140.72
| Professional | | $33.04 | $60.81 | $140.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.43 / $62.40 / $85.75
| Professional | | $41.43 | $62.40 | $85.75 |