- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.07 / $55.04 / $105.63
| Facility | | $30.07 | $55.04 | $105.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.06 / $16.37 / $16.66
| Professional | | $15.06 | $16.37 | $16.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.64 / $22.60 / $37.25
| Facility | | $21.64 | $22.60 | $37.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.65 / $13.78 / $34.96
| Professional | | $9.65 | $13.78 | $34.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.26 / $43.85 / $77.08
| Facility | | $17.26 | $43.85 | $77.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.24 / $20.30 / $26.33
| Professional | | $13.24 | $20.30 | $26.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.43 / $18.89 / $29.39
| Professional | | $6.43 | $18.89 | $29.39 |