- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.05 / $76.81 / $171.02
| Facility | | $31.05 | $76.81 | $171.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.22 / $16.54 / $19.76
| Professional | | $14.22 | $16.54 | $19.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.33 / $23.32 / $38.47
| Facility | | $22.33 | $23.32 | $38.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.94 / $14.22 / $36.11
| Professional | | $9.94 | $14.22 | $36.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.76 / $45.27 / $79.58
| Facility | | $17.76 | $45.27 | $79.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.78 / $20.98 / $27.36
| Professional | | $13.78 | $20.98 | $27.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.64 / $13.85 / $30.34
| Professional | | $6.64 | $13.85 | $30.34 |