- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.28 / $33.46 / $70.67
| Facility | | $18.28 | $33.46 | $70.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.08 / $10.08 / $11.63
| Professional | | $10.08 | $10.08 | $11.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.48 / $15.12 / $22.65
| Facility | | $14.48 | $15.12 | $22.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.45 / $9.22 / $21.28
| Professional | | $6.45 | $9.22 | $21.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.51 / $26.66 / $46.87
| Facility | | $10.51 | $26.66 | $46.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.05 / $12.35 / $17.55
| Professional | | $8.05 | $12.35 | $17.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.16 / $12.29 / $21.32
| Professional | | $5.16 | $12.29 | $21.32 |