- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.28 / $26.67 / $54.52
| Facility | | $15.28 | $26.67 | $54.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.86 / $14.91 / $17.61
| Professional | | $12.86 | $14.91 | $17.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.64 / $21.85 / $64.48
| Facility | | $18.64 | $21.85 | $64.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.46 / $7.83 / $18.45
| Professional | | $7.46 | $7.83 | $18.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.25 / $27.03 / $54.17
| Facility | | $12.25 | $27.03 | $54.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.01 / $21.48 / $26.85
| Professional | | $9.01 | $21.48 | $26.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.83 / $11.18 / $22.37
| Professional | | $7.83 | $11.18 | $22.37 |