- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.28 / $111.72 / $284.61
| Facility | | $21.28 | $111.72 | $284.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.43 / $15.12 / $21.28
| Professional | | $12.43 | $15.12 | $21.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.36 / $14.77 / $46.29
| Facility | | $14.36 | $14.77 | $46.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $19.41 / $24.26
| Professional | | $10.60 | $19.41 | $24.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.80 / $19.32 / $75.61
| Facility | | $16.80 | $19.32 | $75.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.86 / $13.57 / $19.55
| Professional | | $12.86 | $13.57 | $19.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.06 / $9.93 / $10.08
| Professional | | $7.06 | $9.93 | $10.08 |