- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.14 / $58.83 / $105.16
| Facility | | $32.14 | $58.83 | $105.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.81 / $17.53 / $23.64
| Professional | | $12.81 | $17.53 | $23.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.20 / $24.23 / $33.81
| Facility | | $23.20 | $24.23 | $33.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.78 / $14.78 / $37.36
| Professional | | $14.78 | $14.78 | $37.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.30 / $46.85 / $82.36
| Facility | | $19.30 | $46.85 | $82.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.14 / $22.72 / $28.39
| Professional | | $14.14 | $22.72 | $28.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.90 / $13.71 / $38.84
| Professional | | $6.90 | $13.71 | $38.84 |