- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.47 / $52.86 / $135.37
| Facility | | $15.47 | $52.86 | $135.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.96 / $13.00 / $17.44
| Professional | | $11.96 | $13.00 | $17.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.59 / $18.64 / $50.48
| Facility | | $14.59 | $18.64 | $50.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.05 / $7.20 / $16.30
| Professional | | $7.05 | $7.20 | $16.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.19 / $24.41 / $48.84
| Facility | | $10.19 | $24.41 | $48.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.19 / $16.93 / $21.24
| Professional | | $9.19 | $16.93 | $21.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.13 / $8.75 / $20.38
| Professional | | $6.13 | $8.75 | $20.38 |