- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.48 / $160.30 / $346.47
| Facility | | $44.48 | $160.30 | $346.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.84 / $24.20 / $24.63
| Professional | | $21.84 | $24.20 | $24.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.00 / $33.42 / $55.10
| Facility | | $32.00 | $33.42 | $55.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.27 / $20.38 / $51.73
| Professional | | $14.27 | $20.38 | $51.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.51 / $64.86 / $114.03
| Facility | | $25.51 | $64.86 | $114.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.69 / $30.03 / $39.24
| Professional | | $19.69 | $30.03 | $39.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.41 / $22.05 / $43.47
| Professional | | $11.41 | $22.05 | $43.47 |