- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.83 / $145.41 / $471.81
| Facility | | $10.83 | $145.41 | $471.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.30 / $6.77 / $10.24
| Professional | | $6.30 | $6.77 | $10.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.41 / $18.26 / $31.49
| Facility | | $10.41 | $18.26 | $31.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.05 / $9.31 / $14.60
| Professional | | $7.05 | $9.31 | $14.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.46 / $8.46 / $8.46
| Facility | | $8.46 | $8.46 | $8.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $18.14 / $51.71
| Facility | | $5.50 | $18.14 | $51.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $5.62 / $11.87
| Professional | | $4.05 | $5.62 | $11.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $4.33 / $15.13
| Professional | | $3.15 | $4.33 | $15.13 |