- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.31 / $53.66 / $142.97
| Facility | | $29.31 | $53.66 | $142.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.24 / $16.00 / $16.23
| Professional | | $13.24 | $16.00 | $16.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.08 / $22.02 / $36.31
| Facility | | $21.08 | $22.02 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.40 / $13.43 / $34.08
| Professional | | $9.40 | $13.43 | $34.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.76 / $42.72 / $75.11
| Facility | | $16.76 | $42.72 | $75.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.89 / $19.80 / $25.81
| Professional | | $12.89 | $19.80 | $25.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.52 / $13.07 / $33.39
| Professional | | $7.52 | $13.07 | $33.39 |