- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.67 / $137.74 / $385.88
| Facility | | $19.67 | $137.74 | $385.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.14 / $13.62 / $23.56
| Professional | | $12.14 | $13.62 | $23.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.73 / $16.18 / $50.70
| Facility | | $15.73 | $16.18 | $50.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.57 / $21.06 / $26.33
| Professional | | $8.57 | $21.06 | $26.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.39 / $21.16 / $74.52
| Facility | | $18.39 | $21.16 | $74.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.09 / $14.93 / $21.15
| Professional | | $14.09 | $14.93 | $21.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.73 / $7.98 / $11.04
| Professional | | $7.73 | $7.98 | $11.04 |