- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.19 / $38.79 / $82.34
| Facility | | $21.19 | $38.79 | $82.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.28 / $11.65 / $13.48
| Professional | | $11.28 | $11.65 | $13.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.87 / $17.61 / $18.32
| Facility | | $16.87 | $17.61 | $18.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.74 / $10.74 / $24.65
| Professional | | $10.74 | $10.74 | $24.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.70 / $30.89 / $54.31
| Facility | | $12.70 | $30.89 | $54.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.31 / $16.52 / $20.65
| Professional | | $9.31 | $16.52 | $20.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $10.85 / $25.62
| Professional | | $5.01 | $10.85 | $25.62 |