- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.77 / $56.78 / $95.93
| Facility | | $13.77 | $56.78 | $95.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.06 / $11.48 / $16.22
| Professional | | $10.06 | $11.48 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.08 / $13.46 / $42.18
| Facility | | $13.08 | $13.46 | $42.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.17 / $17.35 / $21.68
| Professional | | $7.17 | $17.35 | $21.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.30 / $17.60 / $61.97
| Facility | | $15.30 | $17.60 | $61.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.71 / $12.48 / $17.55
| Professional | | $11.71 | $12.48 | $17.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.43 / $6.55 / $9.18
| Professional | | $6.43 | $6.55 | $9.18 |