- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.56 / $85.05 / $138.40
| Facility | | $34.56 | $85.05 | $138.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.13 / $13.45 / $15.95
| Professional | | $11.13 | $13.45 | $15.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.86 / $13.23 / $41.46
| Facility | | $12.86 | $13.23 | $41.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.51 / $17.35 / $21.68
| Professional | | $9.51 | $17.35 | $21.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.05 / $17.30 / $67.76
| Facility | | $15.05 | $17.30 | $67.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.52 / $12.21 / $17.16
| Professional | | $11.52 | $12.21 | $17.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.02 / $12.71 / $15.05
| Professional | | $9.02 | $12.71 | $15.05 |