- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.53 / $58.35 / $71.45
| Facility | | $46.53 | $58.35 | $71.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $8.64 / $12.55
| Professional | | $8.32 | $8.64 | $12.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.87 / $21.16 / $23.75
| Professional | | $15.87 | $21.16 | $23.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.98 / $12.10 / $15.21
| Professional | | $11.98 | $12.10 | $15.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.46 / $17.71 / $49.90
| Facility | | $7.46 | $17.71 | $49.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $12.60 / $21.00
| Professional | | $5.01 | $12.60 | $21.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.41 / $6.68 / $16.36
| Professional | | $4.41 | $6.68 | $16.36 |