- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.07 / $61.86 / $207.21
| Facility | | $22.07 | $61.86 | $207.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.14 / $13.30 / $23.56
| Professional | | $12.14 | $13.30 | $23.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.47 / $14.72 / $20.05
| Professional | | $12.47 | $14.72 | $20.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.02 / $12.09 / $23.81
| Facility | | $9.02 | $12.09 | $23.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $14.36 / $26.33
| Professional | | $9.02 | $14.36 | $26.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.39 / $23.00 / $27.60
| Professional | | $18.39 | $23.00 | $27.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.73 / $8.28 / $11.96
| Professional | | $7.73 | $8.28 | $11.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.18 / $9.19 / $14.63
| Professional | | $7.18 | $9.19 | $14.63 |