- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.48 / $32.01 / $68.73
| Facility | | $17.48 | $32.01 | $68.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.66 / $10.06 / $10.46
| Professional | | $8.66 | $10.06 | $10.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.60 / $14.21 / $21.66
| Facility | | $13.60 | $14.21 | $21.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.06 / $8.66 / $21.98
| Professional | | $6.06 | $8.66 | $21.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.76 / $27.57 / $48.47
| Facility | | $10.76 | $27.57 | $48.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.41 / $8.88 / $16.52
| Professional | | $8.41 | $8.88 | $16.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $7.47 / $18.48
| Professional | | $3.15 | $7.47 | $18.48 |