- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.17 / $57.07 / $121.43
| Facility | | $31.17 | $57.07 | $121.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.08 / $17.00 / $17.26
| Professional | | $14.08 | $17.00 | $17.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.43 / $23.42 / $38.61
| Facility | | $22.43 | $23.42 | $38.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $14.28 / $36.22
| Professional | | $10.00 | $14.28 | $36.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.76 / $45.46 / $79.91
| Facility | | $17.76 | $45.46 | $79.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.78 / $21.05 / $27.36
| Professional | | $13.78 | $21.05 | $27.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.35 / $15.96 / $33.39
| Professional | | $7.35 | $15.96 | $33.39 |