- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.43 / $61.20 / $117.42
| Facility | | $33.43 | $61.20 | $117.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.73 / $18.37 / $21.26
| Professional | | $16.73 | $18.37 | $21.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.05 / $25.12 / $41.42
| Facility | | $24.05 | $25.12 | $41.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $15.32 / $38.86
| Professional | | $10.72 | $15.32 | $38.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.01 / $48.75 / $85.70
| Facility | | $19.01 | $48.75 | $85.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.67 / $22.58 / $29.43
| Professional | | $14.67 | $22.58 | $29.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $24.15 / $33.39
| Professional | | $7.15 | $24.15 | $33.39 |