- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.51 / $107.47 / $140.90
| Facility | | $20.51 | $107.47 | $140.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.40 / $14.24 / $20.51
| Professional | | $12.40 | $14.24 | $20.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.32 / $14.73 / $46.16
| Facility | | $14.32 | $14.73 | $46.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $19.41 / $24.26
| Professional | | $10.60 | $19.41 | $24.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.75 / $19.26 / $75.37
| Facility | | $16.75 | $19.26 | $75.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.83 / $13.57 / $19.14
| Professional | | $12.83 | $13.57 | $19.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.04 / $9.96 / $10.05
| Professional | | $7.04 | $9.96 | $10.05 |