- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.69 / $52.51 / $102.93
| Facility | | $28.69 | $52.51 | $102.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.68 / $14.68 / $18.23
| Professional | | $14.68 | $14.68 | $18.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.08 / $22.02 / $35.54
| Facility | | $21.08 | $22.02 | $35.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.40 / $13.43 / $33.35
| Professional | | $9.40 | $13.43 | $33.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.51 / $41.84 / $73.55
| Facility | | $16.51 | $41.84 | $73.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.71 / $19.37 / $25.81
| Professional | | $12.71 | $19.37 | $25.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.52 / $22.50 / $28.64
| Professional | | $7.52 | $22.50 | $28.64 |