- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.05 / $79.08 / $107.48
| Facility | | $20.05 | $79.08 | $107.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.03 / $5.84 / $6.70
| Professional | | $5.03 | $5.84 | $6.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.89 / $8.24 / $13.58
| Facility | | $7.89 | $8.24 | $13.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.52 / $5.03 / $12.76
| Professional | | $3.52 | $5.03 | $12.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.25 / $15.98 / $28.09
| Facility | | $6.25 | $15.98 | $28.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.83 / $7.41 / $9.81
| Professional | | $4.83 | $7.41 | $9.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $5.62 / $10.72
| Professional | | $2.35 | $5.62 | $10.72 |