- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.43 / $53.88 / $166.36
| Facility | | $29.43 | $53.88 | $166.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.66 / $16.05 / $16.29
| Professional | | $15.66 | $16.05 | $16.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.18 / $22.12 / $36.46
| Facility | | $21.18 | $22.12 | $36.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $13.49 / $34.21
| Professional | | $9.44 | $13.49 | $34.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.76 / $42.91 / $75.44
| Facility | | $16.76 | $42.91 | $75.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.17 / $13.82 / $25.81
| Professional | | $5.17 | $13.82 | $25.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $13.13 / $28.77
| Professional | | $3.15 | $13.13 | $28.77 |