- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.03 / $78.76 / $103.26
| Facility | | $15.03 | $78.76 | $103.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.77 / $10.09 / $15.03
| Professional | | $8.77 | $10.09 | $15.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.15 / $10.44 / $32.72
| Facility | | $10.15 | $10.44 | $32.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.48 / $13.63 / $17.04
| Professional | | $7.48 | $13.63 | $17.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.87 / $13.65 / $53.42
| Facility | | $11.87 | $13.65 | $53.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.09 / $9.76 / $13.57
| Professional | | $9.09 | $9.76 | $13.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.99 / $7.01 / $7.12
| Professional | | $4.99 | $7.01 | $7.12 |