- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.46 / $97.85 / $141.08
| Facility | | $27.46 | $97.85 | $141.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.41 / $14.63 / $15.93
| Professional | | $14.41 | $14.63 | $15.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.75 / $20.63 / $34.02
| Facility | | $19.75 | $20.63 | $34.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.81 / $12.58 / $31.93
| Professional | | $8.81 | $12.58 | $31.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.76 / $40.04 / $70.40
| Facility | | $15.76 | $40.04 | $70.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.17 / $18.54 / $24.26
| Professional | | $12.17 | $18.54 | $24.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.04 / $12.60 / $26.83
| Professional | | $7.04 | $12.60 | $26.83 |