- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.48 / $39.68 / $175.92
| Facility | | $19.48 | $39.68 | $175.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.86 / $14.78 / $19.48
| Professional | | $11.86 | $14.78 | $19.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.47 / $10.16 / $11.76
| Professional | | $8.47 | $10.16 | $11.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.73 / $20.32 / $27.34
| Facility | | $16.73 | $20.32 | $27.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.76 / $12.38 / $17.29
| Professional | | $11.76 | $12.38 | $17.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.25 / $17.85 / $53.40
| Facility | | $13.25 | $17.85 | $53.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.88 / $16.23 / $24.26
| Professional | | $8.88 | $16.23 | $24.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.11 / $9.94 / $23.67
| Professional | | $7.11 | $9.94 | $23.67 |