- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $56.28 / $154.11
| Facility | | $10.72 | $56.28 | $154.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.63 / $8.80 / $12.65
| Professional | | $7.63 | $8.80 | $12.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.40 / $9.67 / $30.31
| Facility | | $9.40 | $9.67 | $30.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.30 / $12.80 / $16.00
| Professional | | $5.30 | $12.80 | $16.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.00 / $12.65 / $44.55
| Facility | | $11.00 | $12.65 | $44.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.42 / $8.96 / $12.77
| Professional | | $8.42 | $8.96 | $12.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.62 / $5.00 / $6.60
| Professional | | $4.62 | $5.00 | $6.60 |