- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.87 / $52.84 / $101.37
| Facility | | $28.87 | $52.84 | $101.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.46 / $15.32 / $15.37
| Professional | | $14.46 | $15.32 | $15.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.76 / $21.68 / $35.76
| Facility | | $20.76 | $21.68 | $35.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.25 / $13.22 / $33.56
| Professional | | $9.25 | $13.22 | $33.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.51 / $42.08 / $73.98
| Facility | | $16.51 | $42.08 | $73.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.71 / $19.50 / $25.81
| Professional | | $12.71 | $19.50 | $25.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.40 / $12.60 / $28.21
| Professional | | $7.40 | $12.60 | $28.21 |