- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.32 / $57.49 / $175.34
| Facility | | $17.32 | $57.49 | $175.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.56 / $13.15 / $17.60
| Professional | | $10.56 | $13.15 | $17.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.54 / $9.05 / $10.47
| Professional | | $7.54 | $9.05 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.73 / $20.32 / $27.34
| Facility | | $16.73 | $20.32 | $27.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.46 / $11.01 / $15.38
| Professional | | $10.46 | $11.01 | $15.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.78 / $15.88 / $47.24
| Facility | | $11.78 | $15.88 | $47.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.85 / $11.59 / $21.68
| Professional | | $7.85 | $11.59 | $21.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.33 / $8.85 / $21.06
| Professional | | $6.33 | $8.85 | $21.06 |