- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.56 / $43.45 / $100.80
| Facility | | $29.56 | $43.45 | $100.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.53 / $5.65 / $8.61
| Professional | | $4.53 | $5.65 | $8.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.74 / $13.04 / $14.56
| Professional | | $9.74 | $13.04 | $14.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.43 / $7.51 / $9.44
| Professional | | $7.43 | $7.51 | $9.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.47 / $31.61 / $61.97
| Facility | | $6.47 | $31.61 | $61.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.24 / $4.53 / $12.94
| Professional | | $3.24 | $4.53 | $12.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.72 / $6.60 / $11.10
| Professional | | $2.72 | $6.60 | $11.10 |