- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.51 / $50.36 / $96.60
| Facility | | $27.51 | $50.36 | $96.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.78 / $15.12 / $16.80
| Professional | | $13.78 | $15.12 | $16.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.79 / $20.66 / $34.08
| Facility | | $19.79 | $20.66 | $34.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.82 / $12.60 / $16.62
| Professional | | $8.82 | $12.60 | $16.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.76 / $40.10 / $70.50
| Facility | | $15.76 | $40.10 | $70.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.17 / $18.57 / $24.26
| Professional | | $12.17 | $18.57 | $24.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.06 / $12.60 / $26.88
| Professional | | $7.06 | $12.60 | $26.88 |