- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.57 / $68.51 / $112.65
| Facility | | $17.57 | $68.51 | $112.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $9.65 / $10.74
| Professional | | $9.36 | $9.65 | $10.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.65 / $13.21 / $21.78
| Facility | | $12.65 | $13.21 | $21.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.64 / $8.06 / $20.45
| Professional | | $5.64 | $8.06 | $20.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.52 / $25.62 / $45.04
| Facility | | $23.52 | $25.62 | $45.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.25 / $15.04 / $26.85
| Professional | | $8.25 | $15.04 | $26.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.51 / $9.01 / $17.18
| Professional | | $4.51 | $9.01 | $17.18 |