- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $85.11 / $245.47
| Facility | | $21.88 | $85.11 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $15.14 / $66.07
| Professional | | $12.02 | $15.14 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $23.44 / $77.62
| Facility | | $16.98 | $23.44 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $11.48 / $33.11
| Professional | | $8.32 | $11.48 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $32.36 / $77.62
| Facility | | $10.96 | $32.36 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $22.39 / $42.66
| Professional | | $11.22 | $22.39 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $16.98 / $22.91
| Facility | | $8.32 | $16.98 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $10.00 / $23.44
| Professional | | $7.08 | $10.00 | $23.44 |