- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.63 / $53.44 / $84.33
| Facility | | $34.63 | $53.44 | $84.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.02 / $9.75 / $17.62
| Professional | | $8.02 | $9.75 | $17.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.85 / $12.36 / $20.05
| Professional | | $10.85 | $12.36 | $20.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.10 / $9.01 / $17.32
| Facility | | $7.10 | $9.01 | $17.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.77 / $13.83 / $36.13
| Professional | | $6.77 | $13.83 | $36.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.39 / $16.73 / $20.09
| Professional | | $13.39 | $16.73 | $20.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $8.02 / $10.18
| Professional | | $6.03 | $8.02 | $10.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.03 / $13.14 / $13.14
| Professional | | $9.03 | $13.14 | $13.14 |