- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.04 / $51.33 / $106.42
| Facility | | $28.04 | $51.33 | $106.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.13 / $14.88 / $15.48
| Professional | | $11.13 | $14.88 | $15.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.16 / $21.06 / $34.74
| Facility | | $20.16 | $21.06 | $34.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.99 / $12.84 / $32.61
| Professional | | $8.99 | $12.84 | $32.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.01 / $40.88 / $71.86
| Facility | | $16.01 | $40.88 | $71.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.35 / $18.94 / $24.78
| Professional | | $12.35 | $18.94 | $24.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.30 / $12.51 / $27.39
| Professional | | $6.30 | $12.51 | $27.39 |