- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.51 / $81.27 / $106.55
| Facility | | $15.51 | $81.27 | $106.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.07 / $10.41 / $15.51
| Professional | | $9.07 | $10.41 | $15.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $10.77 / $33.74
| Facility | | $10.47 | $10.77 | $33.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.64 / $14.04 / $17.55
| Professional | | $7.64 | $14.04 | $17.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.25 / $14.09 / $55.12
| Facility | | $12.25 | $14.09 | $55.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.38 / $10.03 / $13.96
| Professional | | $9.38 | $10.03 | $13.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.15 / $7.24 / $7.35
| Professional | | $5.15 | $7.24 | $7.35 |