- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $34.86 / $73.31
| Facility | | $19.05 | $34.86 | $73.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.46 / $10.46 / $12.12
| Professional | | $10.46 | $10.46 | $12.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.02 / $15.68 / $23.60
| Facility | | $15.02 | $15.68 | $23.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.69 / $9.56 / $22.14
| Professional | | $6.69 | $9.56 | $22.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.01 / $27.76 / $48.80
| Facility | | $11.01 | $27.76 | $48.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.41 / $12.86 / $18.07
| Professional | | $8.41 | $12.86 | $18.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.46 / $8.50 / $20.39
| Professional | | $4.46 | $8.50 | $20.39 |