- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.39 / $79.25 / $112.67
| Facility | | $16.39 | $79.25 | $112.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $11.68 / $16.39
| Professional | | $10.60 | $11.68 | $16.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.24 / $12.59 / $39.47
| Facility | | $12.24 | $12.59 | $39.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.10 / $16.52 / $20.65
| Professional | | $8.10 | $16.52 | $20.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.32 / $16.47 / $58.28
| Facility | | $14.32 | $16.47 | $58.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $11.67 / $16.36
| Professional | | $10.96 | $11.67 | $16.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.01 / $7.70 / $8.59
| Professional | | $6.01 | $7.70 | $8.59 |