- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.91 / $56.88 / $94.40
| Facility | | $27.91 | $56.88 | $94.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.03 / $16.48 / $22.16
| Professional | | $14.03 | $16.48 | $22.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.36 / $17.52 / $28.22
| Professional | | $15.36 | $17.52 | $28.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.05 / $13.13 / $24.54
| Facility | | $10.05 | $13.13 | $24.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.05 / $20.14 / $30.91
| Professional | | $10.05 | $20.14 | $30.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.96 / $23.70 / $28.44
| Professional | | $18.96 | $23.70 | $28.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.52 / $11.38 / $14.41
| Professional | | $8.52 | $11.38 | $14.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.39 / $9.48 / $18.61
| Professional | | $7.39 | $9.48 | $18.61 |