- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $67.34 / $120.88
| Facility | | $10.72 | $67.34 | $120.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.03 / $5.84 / $8.02
| Professional | | $5.03 | $5.84 | $8.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.70 / $8.56 / $23.18
| Facility | | $6.70 | $8.56 | $23.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.31 / $4.01 / $7.48
| Professional | | $3.31 | $4.01 | $7.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.68 / $11.23 / $22.45
| Facility | | $4.68 | $11.23 | $22.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.33 / $7.85 / $10.16
| Professional | | $4.33 | $7.85 | $10.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.04 / $6.70 / $8.42
| Facility | | $5.04 | $6.70 | $8.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $4.30 / $10.72
| Professional | | $2.81 | $4.30 | $10.72 |