- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.76 / $56.49 / $117.03
| Facility | | $10.76 | $56.49 | $117.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.40 / $10.45 / $12.29
| Professional | | $7.40 | $10.45 | $12.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.36 / $12.71 / $39.85
| Facility | | $12.36 | $12.71 | $39.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.30 / $16.93 / $21.17
| Professional | | $5.30 | $16.93 | $21.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.46 / $16.63 / $58.56
| Facility | | $14.46 | $16.63 | $58.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.07 / $11.67 / $16.76
| Professional | | $11.07 | $11.67 | $16.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $6.07 / $8.68
| Professional | | $5.01 | $6.07 | $8.68 |