- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.28 / $183.75 / $238.67
| Facility | | $16.28 | $183.75 | $238.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.02 / $10.19 / $15.24
| Professional | | $7.02 | $10.19 | $15.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.32 / $11.64 / $36.50
| Facility | | $11.32 | $11.64 | $36.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.79 / $15.28 / $19.10
| Professional | | $7.79 | $15.28 | $19.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.25 / $15.24 / $59.66
| Facility | | $13.25 | $15.24 | $59.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.14 / $10.85 / $15.16
| Professional | | $10.14 | $10.85 | $15.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.57 / $7.60 / $7.95
| Professional | | $5.57 | $7.60 | $7.95 |